Kittiskulnam Piyawan, Johansen Kirsten L
Division of Internal Medicine-Nephrology, Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Special Task force for Activating Research in Renal Nutrition (Renal Nutrition Research Group), Office of Research Affairs, Chulalongkorn University, Bangkok, Thailand.
Semin Dial. 2019 Nov;32(6):485-489. doi: 10.1111/sdi.12834. Epub 2019 Jul 23.
Several epidemiological cohorts have demonstrated that higher body mass index (BMI) is associated with lower mortality risk among patients receiving hemodialysis. However, BMI may be an inaccurate indicator of nutritional status among dialysis patients because it does not differentiate between muscle and fat mass or provide information about body fat distribution. More sophisticated methods of body composition analysis are therefore required to address the question of which component is associated with greater survival. Recent evidence has also shown that changes in body weight and body composition are more strongly associated with mortality in dialysis patients than measurement of BMI at a single time point. Given that obesity is common among the dialysis population, weight loss interventions are encouraged for obese dialysis patients who are on a transplant waiting list in order to increase the access for transplantation.
几个流行病学队列研究表明，较高的体重指数（BMI）与接受血液透析的患者较低的死亡风险相关。然而，BMI可能不是透析患者营养状况的准确指标，因为它无法区分肌肉和脂肪量，也无法提供身体脂肪分布的信息。因此，需要更复杂的身体成分分析方法来解决哪个成分与更高的生存率相关的问题。最近的证据还表明，与单次测量BMI相比，体重和身体成分的变化与透析患者的死亡率更密切相关。鉴于肥胖在透析人群中很常见，对于等待移植的肥胖透析患者，鼓励进行减肥干预，以增加移植的机会。
