Metabolically Abnormal Non-Obese Phenotype Is Significantly Associated with All-Cause Mortality in Hemodialysis Patients

Jin Hyeog Lee, Hae Ryong Yun, Hyung Woo Kim, Jung Tak Park, Seung Hyeok Han, Yong Lim Kim, Yon Su Kim, Chul Woo Yang, Nam Ho Kim, Shin Wook Kang, Tae Hyun Yoo

Research output: Contribution to journalArticlepeer-review

Abstract

The association between obesity and all-cause mortality in patients undergoing kidney failure with replacement therapy (KFRT) has shown conflicting results. This study aimed to evaluate whether metabolic abnormalities (MA) increase the risk of all-cause mortality in these patients. Between 2009 and 2015, 1141 patients undergoing KFRT were recruited from the Clinical Research Center for End-Stage Renal Disease dataset. Patients were divided into four groups according to the presence of obesity and MA. Multivariate Cox proportional hazard analysis was performed to determine the association between the phenotypes and all-cause mortality. During a mean follow-up of 4.2 years, all-cause mortality was observed in 491 (43.0%) patients. Obesity had a 24% decreased risk of all-cause mortality compared with non-obesity. In contrast, the presence of MA showed a 1.53-fold increased risk of all-cause mortality. There was a significant interaction between obesity and MA (p = 0.006). In Cox proportional hazard analyses after adjustment of confounding factors, the metabolically abnormal non-obesity (MANO) phenotype showed a 1.63-fold increased risk of all-cause mortality compared with the metabolically healthy non-obesity phenotype. In subgroup analysis, the risk of all-cause mortality was higher in the MANO phenotype; this phenotype was significantly associated with a higher all-cause mortality in patients undergoing KFRT.

Original languageEnglish
Article number1059
JournalJournal of Clinical Medicine
Volume13
Issue number4
DOIs
StatePublished - Feb 2024

Bibliographical note

Publisher Copyright:
© 2024 by the authors.

Keywords

  • all-cause mortality
  • kidney failure with renal replacement therapy
  • metabolic abnormality
  • obesity

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