Survival Predictability of Lean and Fat Mass in Men and Women Undergoing Maintenance Hemodialysis 1,2,3

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First published online September 15, 2010; doi: 10.3945/ajcn.2010.29188

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Survival predictability of lean and fat mass in men and women undergoing maintenance hemodialysis 1,2,3


Nazanin Noori, Csaba P Kovesdy, Ramanath Dukkipati, Youngmee Kim, Uyen Duong, Rachelle Bross, Antigone Oreopoulos, Amanda Luna, Debbie Benner, Joel D Kopple, and Kamyar Kalantar-Zadeh


Harold Simmons Center for Kidney Disease Research and Epidemiology , & Los Angeles Biomedical Research Institute at Harbor– UCLA Medical Center, Torrance, CA


Design: In 742 MHD patients, including 31% African Americans with a mean (±SD) age of 54 ± 15 y, we categorized men (n = 391) and women (n = 351) separately into 4 quartiles of near-infrared interactance–measured LBM and FM. Cox proportional hazards models estimated death hazard ratios (HRs) (and 95% CIs), and cubic spline models were used to examine associations with mortality over 5 y (2001–2006).
Results: After adjustment for case-mix and inflammatory markers, the highest quartiles of FM and LBM were associated with greater survival in women: HRs of 0.38 (95% CI: 0.20, 0.71) and 0.34 (95% CI: 0.17, 0.67), respectively (reference: first quartile). In men, the highest quartiles of FM and percentage FM (FM%) but not of LBM were associated with greater survival: HRs of 0.51 (95% CI: 0.27, 0.96), 0.45 (95% CI: 0.23, 0.88), and 1.17 (95% CI: 0.60, 2.27), respectively. Cubic spline analyses showed greater survival with higher FM% and higher “FM minus LBM percentiles” in both sexes, whereas a higher LBM was protective in women.

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