2018. 12, 29
Verification of "obesity paradox" in patients with chronic kidney disease Tokyo Medical and Dental University
A research group at Tokyo Medical and Dental University has shown that high BMI may have a good prognosis not only in patients with renal failure during dialysis but also in patients with chronic renal failure during the period when dialysis has not been introduced.
In recent years, in hemodialysis patients, a phenomenon called "obesity paradox", in which a higher BMI (body mass index indicating the degree of obesity) is associated with a better prognosis, has attracted attention.However, there is still no uniform standard for optimal BMI in patients with chronic kidney disease (CKD) during the conservative period (without dialysis).
Therefore, this time, the research group used DPC data, which is a large-scale database in Japan, to extract about 2 CKD patients who were urgently hospitalized and had not introduced dialysis, and whether or not they had infectious diseases. We stratified the presence or absence of diabetic complications and examined the relationship between BMI and in-hospital mortality in each group.The results showed that slimming increased the risk of death with or without inflammatory disease complications.Conversely, the higher the BMI, the better the prognosis during hospitalization.In addition, in the non-infectious disease group with diabetes, the benefit of obesity on the prognosis of life was diminished.
Furthermore, in CKD patients without diabetes, high body weight tended to be associated with a good short-term prognosis regardless of the presence or absence of infectious disease.It was suggested that sufficient calorie intake and weight maintenance may be more important in CKD patients in the future.
This outcome may contribute to better nutritional management advances in CKD patients.
Paper information:[PLOS ONE] Short-term prognosis of emergently hospitalized dialysis-independent chronic kidney disease patients: a nationwide retrospective cohort study in Japan
