ArticleJournal of the American Society of Nephrology : JASN2016
Inflammation Modifies the Paradoxical Association between Body Mass Index and Mortality in Hemodialysis Patients.
Article in Journal of the American Society of Nephrology : JASN, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 2 of them syntheses that pooled it.
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Who cites it
52 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Obesity measurement methods estimated mortality risk in patients undergoing hemodialysis: a systematic review and meta-analysis.International urology and nephrology · 2025Pooled it
- Pooled it
- Quality of life measures predict cardiovascular health and physical performance in chronic renal failure patients.PloS one · 2017Trial
- The "obesity paradox" in dosing: a comprehensive analytical review of cockcroft-gault versus CKD-EPI for predicting clearance of narrow-therapeutic-index drugs in patients with BMI > 40 kg/m².European journal of clinical pharmacology · 2026Review
- The Vicious Cycle of Inflammation: How Obesity, Dialysis Catheters, and NETosis Determine Albumin Levels and Prognosis in Hemodialysis Patients.International journal of molecular sciences · 2026Article
- The Obesity Paradox Reconsidered: Evidence from a Multicenter Romanian Hemodialysis Cohort.Journal of clinical medicine · 2026Article
- Post-Hemodialysis Flow-Dependent Hepatic Function Impairment in Individuals With End Stage Kidney Disease and Chronic Inflammation.Hemodialysis international. International Symposium on Home Hemodialysis · 2026Article
- The association between body mass index and mortality in diabetic patients with end-stage renal disease is different in hemodialysis and peritoneal dialysis.Renal failure · 2025Article
- Article
- Influence of autonomic neuropathy, systemic inflammation and other clinical parameters on mortality in dialysis patients.Clinical kidney journal · 2025Article
- Impact of Handgrip Strength on Survival in Hemodialysis Patients.Diagnostics (Basel, Switzerland) · 2024Article
- Chemerin attenuates acute kidney injury by inhibiting ferroptosis via the AMPK/NRF2/SLC7A11 axis.Communications biology · 2024Article
- Relationship between Permanent Catheter Patency and Nutrient Score in Patients Aged >75 Years Requiring Renal Replacement Therapy.Journal of clinical medicine · 2024Article
- Tissue Sodium Accumulation Induces Organ Inflammation and Injury in Chronic Kidney Disease.International journal of molecular sciences · 2023Review
- Effect ofEvidence-based complementary and alternative medicine : eCAM · 2023Article
- Effect of Diet and Supplementation on Serum Vitamin C Concentration and Antioxidant Activity in Dialysis Patients.Nutrients · 2022Article
- Cohort Study and Bias Analysis of the Obesity Paradox Across Stages of Chronic Kidney Disease.Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation · 2022Article
- A Comparative Study of the Efficacy of an Intervention with a Nutritional Supplement for Patients with Chronic Kidney Disease: A Randomized Trial.Journal of clinical medicine · 2022Article
- Malnutrition inflammation score (MIS) is stronger predictor of mortality in hemodialysis patients than waist-to-hip ratio (WHR)-4-year follow-up.International urology and nephrology · 2022Article
- Malnutrition-Inflammation Complex Syndrome and Bone Fractures and Cardiovascular Disease Events in Patients Undergoing Hemodialysis: The Q-Cohort Study.Kidney medicine · 2022Article
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No grant is acknowledged in the PubMed record.
Abstract
High body mass index (BMI) is paradoxically associated with better outcome in hemodialysis (HD) patients. Persistent inflammation commonly features in clinical conditions where the obesity paradox is described. We examined the relationship between BMI and mortality in HD patients, accounting for inflammation, in a historic cohort study of 5904 incident HD patients enrolled in 2007-2009 (312 facilities; 15 European countries) with ≥3 months of follow-up. Patients were classified by presence (n=3231) or absence (n=2673) of inflammation (C-reactive protein ≥10 mg/l and/or albumin ≤35 g/l). Patients were divided into quintiles by BMI (Q1-Q5: <21.5, 21.5-24.0, >24.0-26.4, >26.4-29.8, and >29.8 kg/m(2), respectively). Noninflamed patients in BMI Q5 formed the reference group. During a median follow-up period of 36.7 months, 1929 deaths occurred (822 cardiovascular), with 655 patients censored for renal transplantation and 1183 for loss to follow-up. Greater mortality was observed in inflamed patients (P<0.001). In fully adjusted time-dependent analyses, the all-cause mortality risk in noninflamed patients was higher only in the lowest BMI quintile (hazard ratio [HR, 1.80; 95% confidence interval [95% CI], 1.26 to 2.56). No protective effect was associated with higher BMI quintiles in noninflamed patients. Conversely, higher BMI associated with lower all-cause mortality risk in inflamed patients (HR [95% CI] for Q1: 5.63 [4.25 to 7.46]; Q2: 3.88 [2.91 to 5.17]; Q3: 2.89 [2.16 to 3.89]; Q4: 2.14 [1.59 to 2.90]; and Q5: 1.77 [1.30 to 2.40]). Thus, whereas a protective effect of high BMI was observed in inflamed patients, this effect was mitigated in noninflamed patients.
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