Impact of lower body mass index on risk of all-cause mortality and infection-related death in Japanese chronic kidney disease patients

Tae Yamamoto, Masaaki Nakayama, Mariko Miyazaki, Hiroshi Sato, Masato Matsushima, Toshinobu Sato, Sadayoshi Ito

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Background: Several studies have reported that lower body mass index (BMI) is associated with high mortality in patients with chronic kidney disease (CKD). Rate of infection-related death in CKD patients is increasing. However, the relationship between BMI and infection-related death is unclear. Methods: Overall, 2648 CKD outpatients (estimated glomerular filtration rate < 60 mL/min and/or presenting with proteinuria) under the care of nephrologists were prospectively followed for 5 years. Patients were stratified by quartile of BMI levels. Data on all-cause mortality before progression to end-stage kidney disease (ESKD) and the cause of death were collected. Results: The median follow-up time was 3.9 years (interquartile range, 1.7-5.0); 114 patients died and 308 started renal replacement therapy. The leading causes of death were as follows; cardiovascular (41%), infection-related (21%), and malignancy-related (18%). Advanced age and lower BMI were the significant risk factors for all-cause mortality before progression to ESKD. Advanced age was statistically associated with respective causes of death, while lower BMI was associated with infection-related death only. CKD stage had no significant impact on all-cause or individual mortality. Conclusions: Low BMI was associated with significant risk of all-cause mortality and infection-related death, which may indicate the novel clinical target to improve CKD outcomes.

Original languageEnglish
Article number244
JournalBMC Nephrology
Volume21
Issue number1
DOIs
Publication statusPublished - 2020 Jun 30

Keywords

  • Body mass index
  • Cause of death
  • Chronic kidney disease
  • Infection
  • Outcome

ASJC Scopus subject areas

  • Nephrology

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