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논문분류	춘계학술대회 초록집
제목	The association of dialysis adequacy, body mass index, and mortality among hemodialysis patients
저자	YUNTAC LIM Lim, Gyeonghun Yang, Jinhui Na, Seong Cho, Sung Rok Kim, Yu-Ji Lee
출판정보	2019; 2019(1):
키워드	Hemodialysis \| adequacy \| body mass index \| mortality
초록	We examined whether the association of HD adequacy with mortality differs among hemodialysis (HD) patients with different body mass index (BMI). We retrospectively extracted and examined patient data from the Korean Society of Nephrology registry, which is a nationwide dataset of the medical records of the HD patients, from January 2001 to June 2017. We included the patients who were ≥18 years old and received maintenance HD with twice- or thrice-weekly schedule. We excluded patients with missing data on baseline single-pool Kt/Vurea (spKt/V) and BMI. Patients were categorized into three groups according to baseline BMI (<20 (low), 20 to <23 (normal), and ≥23 (high) kg/m2). Baseline spKt/V was divided into six categories. Among 18,242 patients on HD, the median follow-up duration was 5.2 (IQR, 1.9–8.9) years. In Cox regression analysis, compared to reference (spKt/V 1.2–1.4), lower and higher baseline spKt/V were associated with greater and lower risks for all-cause mortality, respectively. However, among patients with high BMI (n=5,588), the association between higher spKt/V and lower all-cause mortality was attenuated in all adjusted models (P-interaction<0.001). Compared to the patients with normal BMI and target range of spKt/V (1.2–1.4), those with low BMI had higher risk for all-cause mortality at all spKt/V range. However, the increase of spKt/V incrementally narrowed the gap in risk for mortality. Compared to the patients with normal BMI and target range of spKt/V, those with high BMI and spKt/V <1.2 did not have increased risk for mortality despite low dialysis adequacy. Moreover, the patients with high BMI and spKt/V ≥1.2 had lower risk for all-cause mortality compared to the reference group. However, for those patients, spKt/V ≥1.6 did not show additional survival benefit compared to spKt/V 1.4 to <1.6. In conclusion, the association between spKt/V and mortality in HD patients may affect by BMI.
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