The body weight change during the first year of HEMODIALYSIS IS a strong predictor of patient survival

Abstract

Hemodialysis patients are exposed to a high risk of death. We report the influence of the body weight (BW) change (Δ) on the survival in an incident HD patient cohort.Between January 2000 to 2009, 251 patients (age=65,8±14,8 y.o.; F/M=93/158; diabetes=36%) survived at least one year after HD onset and were followed for 44,9 months. The prescribed BW decreased by 6.5±5% at Week 8 (W8) and then increased again. From W8 to W52, the BW Δ was+1,9±7,4%. According to the median of W52-W8 BW Δ (+2.35%), the Kaplan Meier analysis (see figure below) displayed a significant better survival in patients with a BW Δ above the median. These two groups were not different according to age, diabetes or cardiovascular event history but had a significant higher interdialytic weight gain and protein intake. In the Cox model analysis the patient overall mortality was related to age (p<0.0001), to the W52W8 BW Δ (p=0.017), to the CRP level at W52 (p=0.035) and to serum albumin at W52 (p=0.036). Hence weight gain during the first year of HD treatment was found a strong predictor of survival in HD patients. It was associated with a better food intake whereas the patient case-mix was not different. These data highlight the need for understanding what drives food intake in dialysis patients and for careful nutritional follow-up and support in incident HD patients.fx1