[an error occurred while processing this directive]

Analysis of the correlation between body cell mass index and mortality in maintenance hemodialysis patients

  • YU Xian ,
  • WANG Mei ,
  • WANG Yao ,
  • HUANG Yi-Bin
Expand

Received date: 2024-08-01

  Revised date: 2025-03-25

  Online published: 2025-06-12

Abstract

Objective  This study investigates the correlation between the body cell mass index (BCMI), measured using bioelectrical impedance analysis (BIA), and mortality in patients undergoing maintenance hemodialysis (MHD).  Methods  Ninety-two MHD patients from Xishan People's Hospital were selected for this study between October 2020 and April 2021 and were followed for 34 months. The cohort included 27 patients who died and 64 who survived. Clinical data were compared between thetwo groups to identify factors influencing mortality and to evaluate the predictive value of BCMI in predicting death among MHD patients. Results   Multivariate COX regression analysis identified BCMI (HR=0.700, 95% CI:0.508~0.965, P=0.029) and prealbumin (HR=0.993, 95% CI:0.988~0.998, P=0.008) as independent predictors of mortality. The receiver operating characteristic (ROC) curve indicated that BCMI has predictive value for mortality in MHD patients, with an area under the curve (AUC= 0.654, P=0.020) and an optimal cutoff value of 9.95 kg/m2. Compared with the BCMI>9.95 group, the proportion of female patients was significantly higher in the BCMI≤9.95 group (χ2=23.391, P<0.001), and the proportion of patients with sarcopenia was as high as 47.5% (χ2=14.368, P<0.001). Survival curves showed that the survival rate of patients in the BCMI > 9.95 group was much higher than that in the BCMI ≤ 9.95 group (log rank  P = 0.022).  Conclusion  A low BCMI is significantly associated with increased mortality in MHD patients. Low BCMI indicates comorbid sarcopenia and heightened mortality risk. BIA-measured BCMI values can aid in identifying patients with sarcopenia, enabling timely interventions to improve patient prognosis. 

Cite this article

YU Xian , WANG Mei , WANG Yao , HUANG Yi-Bin . Analysis of the correlation between body cell mass index and mortality in maintenance hemodialysis patients[J]. Chinese Journal of Blood Purification, 2025 , 24(06) : 441 -446 . DOI: 10.3969/j.issn.1671-4091.2025.06.001

References

[1] Brinza C, Covic A, Stefan AE, et al. Pulmonary Arterial Hypertension and Adverse Outcomes after Kidney Transplantation: A Systematic Review and Meta-Analysis[J]. J Clin Med. 2022;11(7):1944.
[2] Wang F, Yang C, Long J, et al. Executive summary for the 2015 Annual Data Report of the China Kidney Disease Network (CK-NET) [J]. Kidney Int. 2019;95(3):501-505.
[3] 赵新菊,甘良英,牛庆雨等.中国血液透析患者死亡原因及特点分析-DOPPS研究的启示[J].中国血液净化,2022,21(02):89-93.
[4] Hazara AM, Bhandari S. Early Mortality Rates After Commencement of Maintenance Hemodialysis: A Systematic Review and Meta-Analysis[J]. Ther Apher Dial. 2020;24(3):275-284.
[5] Kuipers J, Verboom LM, Ipema KJR, et al. The Prevalence of Intradialytic Hypotension in Patients on Conventional Hemodialysis: A Systematic Review with Meta-Analysis. Am J Nephrol. 2019;49(6):497-506.
[6] Surov A, Wienke A. Sarcopenia predicts overall survival in patients with malignant hematological diseases: A meta-analysis[J]. Clin Nutr. 2021;40(3):1155-1160.
[7] Damluji AA, Alfaraidhy M, AlHajri N, et al. Sarcopenia and Cardiovascular Diseases[J]. Circulation. 2023;147(20):1534-1553.
[8] 王梅,王垚,杨明,等.体细胞质量指数对维持性血液透析患者肌少症的诊断价值[J].实用临床医药杂志,2024,28(10):68-72.
[9] 丁妍,常立阳,张红梅.相角与维持性血液透析患者肌少症的关系及其预测价值分析[J].中国血液净化,2022,21(03):172-176.
[10] Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment[J]. J Am Med Dir Assoc. 2020;21(3):300-307.e2.
[11] Duarte MP, Almeida LS, Neri SGR, et al. Prevalence of sarcopenia in patients with chronic kidney disease: a global systematic review and meta-analysis [J]. J Cachexia Sarcopenia Muscle. 2024;15(2):501-512.
[12] Bae EH. Is sarcopenia a real risk factor for mortality in patients undergoing hemodialysis? [J]. Korean J Intern Med. 2019;34(3):507-509.
[13] Kim JK, Kim SG, Oh JE, et al. Impact of sarcopenia on long-term mortality and cardiovascular events in patients undergoing hemodialysis[J]. Korean J Intern Med 2019;34:599 607.
[14] Valente A, Caetano C, Oliveira T, et al. Evaluating haemodialysis patient's nutritional status: Body mass index or body cell mass index? [J]. Nephrology (Carlton). 2019;24(9):967-974.
[15] Serón-Arbeloa C, Labarta-Monzón L, Puzo-Foncillas J, et al. Malnutrition Screening and Assessment[J]. Nutrients. 2022;14(12):2392.
[16] Barreto Silva MI, Picard K, Klein MRST. Sarcopenia and sarcopenic obesity in chronic kidney disease: update on prevalence, outcomes, risk factors and nutrition treatment. Curr Opin Clin Nutr Metab Care[J]. 2022;25(6):371-377.
[17] Park JH, Jo YI, Lee JH. Clinical usefulness of bioimpedance analysis for assessing volume status in patients receiving maintenance dialysis[J]. Korean J Intern Med. 2018;33(4):660-669.
[18] 欧琴琴. 体细胞质量指数与维持性血液透析患者认知功能障碍的相关性研究[D].遵义医科大学,2022.
[19] Rondanelli M, Talluri J, Peroni G, et al. Beyond body mass index. Is the body cell mass index (BCMI) a useful prognostic factor to describe nutritional, inflammation and muscle mass status in hospitalized elderly?[J]. Clin Nutr, 2018, 37(3):934-939.
[20] Wu B, Peng Y, Zhang S, et al. Body Composition Analysis as a Predictor of Prognosis for Patients With Acute Kidney Injury Requiring Kidney Replacement Therapy[J]. J Ren Nutr.2021;31(6):560-568.e2.
[21] Yu Q, Wang Z, Ding X. Serum prealbumin as a predictor of adverse outcomes in patients with heart failure: a systematic review and meta-analysis[J]. Biomark Med. 2022;16(7):569-575.
[22] Wu B, Yan C, Zhang S, et al. Comparative Performance of Body Composition Parameters in Prediction of Death in Hospitalized Patients on Maintenance Hemodialysis: A Cohort Study[J]. Sci Rep. 2020;10(1):10199.
[23] 彭玥,龙艳君,周朝敏,等.体细胞质量指数与维持性血液透析患者蛋白质能量消耗的相关性研究[J].中国实用内科志,2020,40(07):571-575.
[24] Barbagallo M, Veronese N, Di Prazza A, et al. Effect of Calcifediol on Physical Performance and Muscle Strength Parameters: A Systematic Review and Meta-Analysis[J]. Nutrients. 2022;14(9):1860.
Options
Outlines

/

[an error occurred while processing this directive]