Evidence map›Paper›PMID 21037042›Full record

ArticleMayo Clinic proceedings2010

The obesity paradox and mortality associated with surrogates of body size and muscle mass in patients receiving hemodialysis.

Kamyar Kalantar-Zadeh, Elani Streja, Csaba P Kovesdy, Antigone Oreopoulos, Nazanin Noori, Jennie Jing, Allen R Nissenson, Mahesh Krishnan, Joel D Kopple, Rajnish Mehrotra and 1 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Mayo Clinic proceedings, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 164 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
164citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

164 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  8. Association of Body Mass Index With Mortality in Peritoneal Dialysis Patients: A Systematic Review and Meta-Analysis.Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis
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104 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kamyar Kalantar-ZadehHarold Simmons Center for Chronic Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90509-2910, USA. kamkal@ucla.edu
Elani Streja
Csaba P Kovesdy
Antigone Oreopoulos
Nazanin Noori
Jennie Jing
Allen R Nissenson
Mahesh Krishnan
Joel D Kopple
Rajnish Mehrotra
Stefan D Anker

Funding

Examining Racial and Cardiovascular Paradoxes in Chronic Kidney DiseaseR01DK078106 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KALANTAR-ZADEH, KAMYAR · 2007 to 2011
$1.1M
NIDDK NIH HHS R01 DK078106
6 · The paper itself

Abstract

objectiveTo determine whether dry weight gain accompanied by an increase in muscle mass is associated with a survival benefit in patients receiving maintenance hemodialysis (HD). PATIENTS AND

methodsIn a nationally representative 5-year cohort of 121,762 patients receiving HD 3 times weekly from July 1, 2001, through June 30, 2006, we examined whether body mass index (BMI) (calculated using 3-month averaged post-HD dry weight) and 3-month averaged serum creatinine levels (a likely surrogate of muscle mass) and their changes over time were predictive of mortality risk.

resultsIn the cohort, higher BMI (up to 45) and higher serum creatinine concentration were incrementally and independently associated with greater survival, even after extensive multivariate adjustment for available surrogates of nutritional status and inflammation. Dry weight loss or gain over time exhibited a graded association with higher rates of mortality or survival, respectively, as did changes in serum creatinine level over time. Among the 50,831 patients who survived the first 6 months and who had available data for changes in weight and creatinine level, those who lost weight but had an increased serum creatinine level had a greater survival rate than those who gained weight but had a decreased creatinine level. These associations appeared consistent across different demographic groups of patients receiving HD.

conclusionIn patients receiving long-term HD, larger body size with more muscle mass appears associated with a higher survival rate. A discordant muscle gain with weight loss over time may confer more survival benefit than weight gain while losing muscle. Controlled trials of muscle-gaining interventions in patients receiving HD are warranted.

Indexed as

Renal DialysisWeight GainBody Mass IndexCohort StudiesCreatineFemaleHumansKidney Failure, ChronicMaleMiddle AgedMuscle, SkeletalObesityProportional Hazards ModelsSurvival AnalysisTime FactorsCreatine

Identifiers

PMID21037042
PMCPMC2966362

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.