Tags

Type your tag names separated by a space and hit enter

Pre-ESRD changes in body weight and survival in nursing home residents starting dialysis.
Clin J Am Soc Nephrol 2013; 8(10):1734-40CJ

Abstract

BACKGROUND AND OBJECTIVES

Among patients receiving maintenance dialysis, weight loss at any body mass index is associated with mortality. However, it is not known whether weight changes before dialysis initiation are associated with mortality and if so, what risks are associated with weight gain or loss.

DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS

Linking data from the US Renal Data System to a national registry of nursing home residents, this study identified 11,090 patients who started dialysis between January of 2000 and December of 2006. Patients were categorized according to weight measured between 3 and 6 months before dialysis initiation and the percentage change in body weight before dialysis initiation (divided into quintiles). The outcome was mortality within 1 year of starting dialysis.

RESULTS

There were 361 patients (3.3%) who were underweight (Quételet's [body mass] index<18.5 kg/m(2)) and 4046 patients (36.5%) who were obese (body mass index ≥ 30 kg/m(2)) before dialysis initiation. The median percentage change in body weight before dialysis initiation was -6% (interquartile range=-13% to 1%). There were 6063 deaths (54.7%) over 1 year of follow-up. Compared with patients with minimal weight changes (-3% to 3%, quintile 4), patients with weight loss ≥ 15% (quintile 1) had 35% higher risk for mortality (95% confidence interval, 1.25 to 1.47), whereas those patients with weight gain ≥ 4% (quintile 5) had a 24% higher risk for mortality (95% confidence interval, 1.14 to 1.35) adjusted for baseline body mass index and other confounders.

CONCLUSIONS

Among nursing home residents, changes in body weight in advance of dialysis initiation are associated with significantly higher 1-year mortality.

Authors+Show Affiliations

Department of Medicine, Stanford University School of Medicine, Palo Alto, California;, Departments of †Epidemiology and Biostatistics and, ‡Medicine, Division of Nephrology, University of California, San Francisco, California, §Geriatrics Research Education and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

24009221

Citation

Stack, Shobha, et al. "Pre-ESRD Changes in Body Weight and Survival in Nursing Home Residents Starting Dialysis." Clinical Journal of the American Society of Nephrology : CJASN, vol. 8, no. 10, 2013, pp. 1734-40.
Stack S, Chertow GM, Johansen KL, et al. Pre-ESRD changes in body weight and survival in nursing home residents starting dialysis. Clin J Am Soc Nephrol. 2013;8(10):1734-40.
Stack, S., Chertow, G. M., Johansen, K. L., Si, Y., & Kurella Tamura, M. (2013). Pre-ESRD changes in body weight and survival in nursing home residents starting dialysis. Clinical Journal of the American Society of Nephrology : CJASN, 8(10), pp. 1734-40. doi:10.2215/CJN.01410213.
Stack S, et al. Pre-ESRD Changes in Body Weight and Survival in Nursing Home Residents Starting Dialysis. Clin J Am Soc Nephrol. 2013;8(10):1734-40. PubMed PMID: 24009221.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pre-ESRD changes in body weight and survival in nursing home residents starting dialysis. AU - Stack,Shobha, AU - Chertow,Glenn M, AU - Johansen,Kirsten L, AU - Si,Yan, AU - Kurella Tamura,Manjula, Y1 - 2013/09/05/ PY - 2013/9/7/entrez PY - 2013/9/7/pubmed PY - 2014/6/26/medline SP - 1734 EP - 40 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 8 IS - 10 N2 - BACKGROUND AND OBJECTIVES: Among patients receiving maintenance dialysis, weight loss at any body mass index is associated with mortality. However, it is not known whether weight changes before dialysis initiation are associated with mortality and if so, what risks are associated with weight gain or loss. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: Linking data from the US Renal Data System to a national registry of nursing home residents, this study identified 11,090 patients who started dialysis between January of 2000 and December of 2006. Patients were categorized according to weight measured between 3 and 6 months before dialysis initiation and the percentage change in body weight before dialysis initiation (divided into quintiles). The outcome was mortality within 1 year of starting dialysis. RESULTS: There were 361 patients (3.3%) who were underweight (Quételet's [body mass] index<18.5 kg/m(2)) and 4046 patients (36.5%) who were obese (body mass index ≥ 30 kg/m(2)) before dialysis initiation. The median percentage change in body weight before dialysis initiation was -6% (interquartile range=-13% to 1%). There were 6063 deaths (54.7%) over 1 year of follow-up. Compared with patients with minimal weight changes (-3% to 3%, quintile 4), patients with weight loss ≥ 15% (quintile 1) had 35% higher risk for mortality (95% confidence interval, 1.25 to 1.47), whereas those patients with weight gain ≥ 4% (quintile 5) had a 24% higher risk for mortality (95% confidence interval, 1.14 to 1.35) adjusted for baseline body mass index and other confounders. CONCLUSIONS: Among nursing home residents, changes in body weight in advance of dialysis initiation are associated with significantly higher 1-year mortality. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/24009221/Pre_ESRD_changes_in_body_weight_and_survival_in_nursing_home_residents_starting_dialysis_ L2 - http://cjasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=24009221 DB - PRIME DP - Unbound Medicine ER -