Evidence map›Paper›PMID 39602028›Full record

ArticleJournal of nephrology2025

Nationwide mortality following acute type B aortic dissection and the survival advantage of obesity among dialysis patients in Japan.

Yuta Nakano, Shintaro Mandai, Yutaro Mori, Fumiaki Ando, Koichiro Susa, Takayasu Mori, Soichiro Iimori, Shotaro Naito, Eisei Sohara, Kiyohide Fushimi and 1 more

Abstract read
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Article in Journal of nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

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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

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Yuta NakanoDepartment of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan.
Shintaro MandaiDepartment of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan. smandai.kid@tmd.ac.jp.ORCID http://orcid.org/0000-0001-6709-306X
Yutaro MoriDepartment of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan.
Fumiaki AndoDepartment of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan.
Koichiro SusaDepartment of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan.
Takayasu MoriDepartment of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan.
Soichiro IimoriDepartment of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan.
Shotaro NaitoDepartment of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan.
Eisei SoharaDepartment of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan.
Kiyohide FushimiDepartment of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan.
Shinichi UchidaDepartment of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8519, Japan.

Funding

Ministry of Health, Labour and Welfare Seisaku-Sitei-20AA2005 to KF
6 · The paper itself

Abstract

backgroundThe incidence of acute type B aortic dissection is higher than that of acute type A aortic dissection among patients on dialysis. However, the impact of being on chronic dialysis on outcomes after type B aortic dissection remains unknown. This study aimed to investigate the trends in in-hospital mortality after type B aortic dissection and the association between body mass index (BMI) and survival paradox on dialysis.

methodsThis study included 48,889 type B aortic dissection hospitalizations in Japan from 2010 to 2020 based on data from a nationwide administrative database. Logistic regression was used to examine mortality risks and restricted cubic spline to investigate the non-linear association between mortality and BMI.

resultsThere were 2,116 in-hospital deaths, and the mortality rates were 8.0% in patients receiving chronic dialysis and 4.3% in patients not receiving dialysis. Patients not receiving dialysis had decreased trends of absolute mortality. Meanwhile, patients receiving chronic dialysis had a higher mortality rate from 2010 to 2020. The mortality risk was high in patients receiving chronic dialysis who were underweight and had normal BMI, but not in those who were overweight. Restricted cubic spline analysis showed that a higher BMI was associated with a lower mortality risk in dialysis patients. This finding contrasted the U-shape observed in patients not receiving dialysis.

conclusionsA lower BMI was associated with a higher risk of in-hospital mortality after type B aortic dissection among dialysis patients, thereby illustrating the obesity paradox. Our findings provide insights that can enhance the management strategies for dialysis patients facing type B aortic dissection.

Indexed as

Aortic DissectionObesityRenal DialysisAcute DiseaseAgedAged, 80 and overBody Mass IndexDatabases, FactualFemaleHospital MortalityHumansJapanMaleMiddle AgedRisk AssessmentRisk FactorsChronic kidney diseaseDialysisObesity paradoxType B aortic dissection

Identifiers

PMID39602028

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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.