Kramer Holly J, Saranathan Anand, Luke Amy, Durazo-Arvizu Ramone A, Guichan Cao, Hou Susan, Cooper Richard
Loyola University Medical Center, Department of Preventive Medicine, 2160 First Avenue, Maywood, IL 60153, USA.
J Am Soc Nephrol. 2006 May;17(5):1453-9. doi: 10.1681/ASN.2005111241. Epub 2006 Apr 5.
An increase in obesity prevalence among patients who initiate dialysis may influence the growth of the total ESRD population as a result of improved survival and decreased likelihood for transplantation. Temporal trends in mean body mass index (BMI) and obesity prevalence were examined among incident patients with ESRD by year of dialysis initiation between 1995 and 2002, and these trends were compared with those in the US population during this same period. Among incident dialysis patients, BMI was calculated with the height and estimated dry weight collected from the Centers for Medicare and Medicaid Services End-Stage Renal Disease Medical Evidence Form. In the US population, self-reported height and weight were used. Prevalence of total obesity and obesity stage > or =2 were defined as a BMI > or =30 and > or =35 kg/m(2), respectively. Among incident patients with ESRD, mean BMI increased from 25.7 to 27.5 kg/m(2), and total obesity and obesity stage > or =2 increased by 33 and 63%, respectively, among incident patients with ESRD (P < 0.0001 for obesity trends). BMI slope was approximately two-fold higher in the incident ESRD population compared with the US population for all age groups. However, temporal increases in obesity prevalence were similar between the two populations. As a result of the survival advantage associated with obesity and decreased likelihood for transplantation, these trends most likely will influence the total number of patients who receive dialysis in the next decade.
开始透析的患者中肥胖患病率的增加，可能会因生存率提高和移植可能性降低而影响终末期肾病（ESRD）总体人群的增长。通过1995年至2002年期间开始透析的年份，对ESRD新发病例患者的平均体重指数（BMI）和肥胖患病率的时间趋势进行了研究，并将这些趋势与同期美国人群的趋势进行了比较。在新发病例透析患者中，BMI是根据从医疗保险和医疗补助服务中心终末期肾病医疗证据表中收集的身高和估计干体重计算得出的。在美国人群中，使用的是自我报告的身高和体重。总体肥胖患病率和肥胖程度≥2分别定义为BMI≥30和≥35 kg/m²。在ESRD新发病例患者中，平均BMI从25.7增加到27.5 kg/m²，ESRD新发病例患者中的总体肥胖和肥胖程度≥2分别增加了33%和63%（肥胖趋势P<0.0001）。所有年龄组中，新发病例ESRD人群的BMI斜率比美国人群高约两倍。然而，两个人群中肥胖患病率的时间增加趋势相似。由于肥胖带来的生存优势以及移植可能性降低，这些趋势很可能会影响未来十年接受透析的患者总数。
