Evidence map›Paper›PMID 25901091›Full record

ArticleClinical journal of the American Society of Nephrology : CJASN2015

Body composition and survival in dialysis patients: results from an international cohort study.

Daniele Marcelli, Len A Usvyat, Peter Kotanko, Inga Bayh, Bernard Canaud, Michael Etter, Emanuele Gatti, Aileen Grassmann, Yuedong Wang, Cristina Marelli and 5 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical journal of the American Society of Nephrology : CJASN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
86citing papers in PubMed, 6 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

86 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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26 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

15 authors.

Daniele MarcelliFresenius Medical Care, Bad Homburg, Germany; Daniele.Marcelli@fmc-ag.de.
Len A UsvyatFresenius Medical Care, Waltham, Massachusetts;
Peter KotankoRenal Research Institute, New York, New York; Mount Sinai Hospital, New York, New York;
Inga BayhFresenius Medical Care, Bad Homburg, Germany;
Bernard CanaudFresenius Medical Care, Bad Homburg, Germany; University of Montpellier I, Montpellier, France;
Michael EtterFresenius Medical Care Asia-Pacific, Hong Kong;
Emanuele GattiFresenius Medical Care, Bad Homburg, Germany; Danube University, Krems, Austria;
Aileen GrassmannFresenius Medical Care, Bad Homburg, Germany;
Yuedong WangUniversity of California-Santa Barbara, Santa Barbara, California;
Cristina MarelliFresenius Medical Care, Buenos Aires, Argentina; and.
Laura ScatizziFresenius Medical Care, Bad Homburg, Germany;
Andrea StopperFresenius Medical Care, Bad Homburg, Germany;
Frank M van der SandeMaastricht University Medical Center, Maastricht, The Netherlands.
Jeroen KoomanMaastricht University Medical Center, Maastricht, The Netherlands.
MONitoring Dialysis Outcomes (MONDO) Consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesHigh body mass index appears protective in hemodialysis patients, but uncertainty prevails regarding which components of body composition, fat or lean body mass, are primarily associated with survival. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data between April 2006 and December 2012 were extracted from the Fresenius Medical Care Europe subset of the international MONitoring Dialysis Outcomes initiative. Fresenius Medical Care Europe archives a unique repository of predialysis body composition measurements determined by multifrequency bioimpedance (BCM Body Composition Monitor). The BCM Body Composition Monitor reports lean tissue indices (LTIs) and fat tissue indices (FTIs), which are the respective tissue masses normalized to height squared, relative to an age- and sex-matched healthy population. The relationship between LTI and FTI and all-cause mortality was studied by Kaplan-Meier analysis, multivariate Cox regression, and smoothing spline ANOVA logistic regression.

resultsIn 37,345 hemodialysis patients, median (25th-75th percentile) LTI and FTI were 12.2 (10.3-14.5) and 9.8 (6.6-12.4) kg/m(2), respectively. Median (25th-75th percentile) follow-up time was 266 (132-379) days; 3458 (9.2%) patients died during follow-up. Mortality was lowest with both LTI and FTI in the 10th-90th percentile (reference group) and significantly higher at the lower LTI and FTI extreme (hazard ratio [HR], 3.37; 95% confidence interval [95% CI], 2.94 to 3.87; P<0.001). Survival was best with LTI between 15 and 20 kg/m(2) and FTI between 4 and 15 kg/m(2) (probability of death during follow-up: <5%). When taking the relation between both compartments into account, the interaction was significant (P=0.01). Higher FTI appeared protective in patients with low LTI (HR, 3.37; 95% CI, 2.94 to 3.87; P<0.001 at low LTI-low FTI, decreasing to HR, 1.79; 95% CI, 1.47 to 2.17; P<0.001 at low LTI-high FTI).

conclusionsThis large international study indicates best survival in patients with both LTI and FTI in the 10th-90th percentiles of a healthy population. In analyses of body composition, both lean tissue and fat tissue compartments and also their relationship should be considered.

Indexed as

Body CompositionRenal DialysisAdiposityAgedAged, 80 and overBody Mass IndexCase-Control StudiesDatabases, FactualElectric ImpedanceEuropeFemaleHumansKaplan-Meier EstimateKidney DiseasesLogistic ModelsMalebioimpedancedialysisfat tissuelean tissuesurvival

Identifiers

PMID25901091
PMCPMC4491292

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.