Shelton B A, Reed R D, MacLennan P A, McWilliams D, Mustian M N, Sawinski D, Kumar V, Ong S, Locke J E
Comprehensive Transplant Institute, University of Alabama at Birmingham, USA.
Renal, Electrolyte and Hypertension Division, University of Pennsylvania, USA.
J Health Sci Educ. 2018;2(5). Epub 2018 Nov 8.
Among ESRD patients, obesity may improve dialysis-survival but decreases likelihood of transplantation, and as such, obesity prevalence may directly affect growth of the dialysis population.
The objective of this study was to assess BMI trends in the ESRD population as compared to the general population.
Incident adult ESRD patients were identified from the United States Renal Data System from 01/01/1995-12/31/2010 (n=1,458,350). Data from the Behavioral Risk Factor Surveillance System (n=4,303,471) represented the US population. Trends in BMI, obesity classes I (BMI of 30-34.9), II (BMI of 35-39.9), and III (BMI ≥ 40), were examined by year of dialysis initiation. Trends in BMI slope were compared between the ESRD and US populations using linear regression.
Mean BMI of ESRD patients in 1995 was 25.2 as compared to 29.4 in 2010, a 16.7% increase, while the US population's mean BMI increased from 25.3 to 27.2, a 7.5% increase. BMI increase among the ESRD population was significantly more rapid than among the US population (β: 0.16, 95% CI: 0.14-0.18, p<0.001).
Mean BMI among the ESRD population is increasing more rapidly than the US population. Given decreased access to kidney transplantation among ESRD patients with obesity, future research should be directed at controlling healthcare expenditures by identifying strategies to address the obesity epidemic among the US ESRD population.
在终末期肾病（ESRD）患者中，肥胖可能会改善透析生存率，但会降低移植的可能性，因此，肥胖患病率可能会直接影响透析人群的增长。
本研究的目的是评估ESRD人群与普通人群相比的体重指数（BMI）趋势。
从美国肾脏数据系统中识别出1995年1月1日至2010年12月31日期间发病的成年ESRD患者（n = 1,458,350）。行为危险因素监测系统的数据（n = 4,303,471）代表美国人群。按透析开始年份检查BMI、I类肥胖（BMI为30 - 34.9）、II类肥胖（BMI为35 - 39.9）和III类肥胖（BMI≥40）的趋势。使用线性回归比较ESRD人群和美国人群之间BMI斜率的趋势。
1995年ESRD患者的平均BMI为25.2，2010年为29.4，增长了16.7%，而美国人群的平均BMI从25.3增加到27.2，增长了7.5%。ESRD人群中BMI的增长明显比美国人群更快（β：0.16，95%置信区间：0.14 - 0.18，p<0.001）。
ESRD人群的平均BMI增长速度比美国人群更快。鉴于肥胖的ESRD患者获得肾脏移植的机会减少，未来的研究应致力于通过确定应对美国ESRD人群肥胖流行的策略来控制医疗保健支出。
