Objective: The aim of this study was to investigate the association of the maximum lifetime body mass index (max BMI) with hemodialysis initiation and comorbidities in Japanese hemodialysis patients. Methods: In a retrospective cross-sectional study on 724 hemodialysis patients, max BMI, age at hemodialysis initiation, and comorbidities including sleep apnea syndrome, cerebro-cardiovascular diseases, and proliferative diabetic retinopathy (PDR) were analyzed. Early hemodialysis initiation was defined as age #x3c;50 years. Result: Diabetes patients showed a higher max BMI and prevalence of atherosclerotic diseases than nondiabetes patients, despite almost the same age at hemodialysis initiation. Patients with early hemodialysis initiation showed higher male ratio, prevalence of PDR, and max BMI than those with later initiation, despite almost equal prevalence of diabetes. Receiver-operating characteristic curve analysis determined a max BMI of 28.4 kg/m² as a reliable cutoff value for predicting early hemodialysis initiation, and this parameter was identified as an independent predictor of early hemodialysis initiation using bivariate logistic regression analysis. Vitrectomy for PDR also tended to contribute independently to early hemodialysis initiation. Conclusion: A high max BMI contributed to early hemodialysis initiation independent of diabetes. Furthermore, PDR was associated with a high max BMI and early hemodialysis initiation. These results suggest that weight reduction in young chronic kidney disease patients with obesity may prevent hemodialysis and blindness.
Obes Facts

中文翻译：

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日本最大终生体重指数与血液透析开始年龄和血管并发症的关系

目的：本研究的目的是调查日本血液透析患者的最大终生体重指数 (max BMI) 与血液透析开始和合并症的关系。方法：在一项对 724 名血液透析患者的回顾性横断面研究中，分析了最大 BMI、血液透析开始时的年龄和合并症，包括睡眠呼吸暂停综合征、脑心血管疾病和增殖性糖尿病视网膜病变 (PDR)。早期血液透析开始被定义为年龄#x3c；50 岁。结果：尽管开始血液透析时的年龄几乎相同，但糖尿病患者的最大 BMI 和动脉粥样硬化疾病的患病率高于非糖尿病患者。尽管糖尿病患病率几乎相同，但早期开始血液透析的患者的男性比例、PDR 患病率和最大 BMI 均高于晚期开始透析的患者。接受者操作特征曲线分析确定最大 BMI 为 28.4 kg/m ²作为预测早期血液透析开始的可靠截止值，并且使用双变量逻辑回归分析将该参数确定为早期血液透析开始的独立预测因子。PDR 的玻璃体切除术也倾向于独立地促进早期血液透析的开始。结论：高最大 BMI 有助于独立于糖尿病的早期血液透析开始。此外，PDR 与高最大 BMI 和早期血液透析开始有关。这些结果表明，肥胖的年轻慢性肾病患者的体重减轻可以预防血液透析和失明。
肥胖事实