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Associations between Body Mass Index in Hemodialysis Patients and Comorbidity, Dialysis Adequacy, Blood Pressure

Lama M AlSahli1, Sara AlHinti1, Razan AlOmar1

  • 1College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|August 10, 2022
PubMed

Insights

Higher body mass index (BMI) in hemodialysis patients is linked to reduced dialysis adequacy but better blood pressure control and lower mortality risk. Obese patients experienced more sepsis hospitalizations, contrasting general population trends.

Area of Science:

  • Nephrology
  • Internal Medicine
  • Public Health

Background:

  • Higher body mass index (BMI) is linked to comorbidities in the general population.
  • In hemodialysis (HD) patients, BMI impacts dialysis adequacy, blood pressure (BP) control, and comorbidity risk.

Purpose of the Study:

  • To investigate the association between BMI and clinical outcomes in hemodialysis patients.
  • To compare dialysis adequacy, BP control, comorbidity burden, and hospitalization rates across different BMI categories in HD patients.

Main Methods:

  • A cross-sectional observational study conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia.
  • 262 adult patients on maintenance hemodialysis for at least six months were included.
  • Retrospective chart review was used to collect data on BMI, dialysis adequacy, BP, Charlson Comorbidity Index (CCI), and hospitalization history.

Main Results:

  • Obesity (34.4%) and normal weight (34.4%) were the most prevalent BMI categories. Diabetes mellitus was the leading cause of chronic kidney disease.
  • A significant relationship was found between BMI and dialysis adequacy (P=0.004), with 60% of obese patients having inadequate dialysis.
  • Obese patients exhibited the lowest postdialysis systolic BP (129.71 ± 18.38 mmHg, P=0.037) and the lowest CCI scores, indicating lower mortality risk.
  • Despite fewer overall hospitalizations, obese patients had higher rates of sepsis-related admissions (P=0.048).

Conclusions:

  • Obese hemodialysis patients demonstrate distinct clinical profiles compared to the general population.
  • While obese HD patients face challenges with dialysis adequacy, they benefit from better BP control and lower comorbidity burden.
  • Further research is needed to understand the implications of these findings for managing obese patients in hemodialysis settings.

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