Obesity, End-stage Renal Disease, and Survival in an Elderly Cohort With Cardiovascular Disease

作者: Janice P. Lea , Daryl O. Crenshaw , Stephen J. Onufrak , Britt B. Newsome , William M. McClellan

DOI: 10.1038/OBY.2009.70

关键词:

摘要: Obesity is highly prevalent in African Americans and associated with increased risk of End-Stage Renal Disease (ESRD) death. It not known if the effect obesity similar among blacks whites. The aim this study to examine racial differences association ESRD survival elderly patients (age >65). Data were obtained for 74,167 Medicare acute myocardial infarction (AMI) between February 1994 July 1995. BMI was calculated as weight (kg) divided by height (m(2)). We evaluated class incidence death using multivariable Cox proportional hazards models, testing race-BMI interactions. Compared whites, had higher (26.9 vs. 26.0, P < 0.0001) estimated glomerular filtration rate (72.4 ml/min/1.73 m(2) 66.6 m(2), 0.0001). Crude rates increasing whites but blacks. However, after adjusting age, sex, other comorbidities, or interaction race significant. Furthermore, both races, classified overweight, 1 obese, 2 obese similar, significantly better abilities compared normal In conclusion, does increase black white subjects cardiovascular disease (CVD). population, experience a benefit. Further studies need explore paradox.

参考文章(21)
Kamyar Kalantar-Zadeh, Kevin C Abbott, Abdulla K Salahudeen, Ryan D Kilpatrick, Tamara B Horwich, Survival advantages of obesity in dialysis patients The American Journal of Clinical Nutrition. ,vol. 81, pp. 543- 554 ,(2005) , 10.1093/AJCN/81.3.543
Rebecca P. Gelber, Tobias Kurth, Annamaria T. Kausz, JoAnn E. Manson, Julie E. Buring, Andrew S. Levey, J. Michael Gaziano, Association between body mass index and CKD in apparently healthy men. American Journal of Kidney Diseases. ,vol. 46, pp. 871- 880 ,(2005) , 10.1053/J.AJKD.2005.08.015
Essam F. Elsayed, Hocine Tighiouart, Daniel E. Weiner, John Griffith, Deeb Salem, Andrew S. Levey, Mark J. Sarnak, Waist-to-Hip Ratio and Body Mass Index as Risk Factors for Cardiovascular Events in CKD American Journal of Kidney Diseases. ,vol. 52, pp. 49- 57 ,(2008) , 10.1053/J.AJKD.2008.04.002
York P.C. Pei, Celia M.T. Greenwood, Anne L. Chery, George G. Wu, Racial differences in survival of patients on dialysis. Kidney International. ,vol. 58, pp. 1293- 1299 ,(2000) , 10.1046/J.1523-1755.2000.00285.X
Jeroan J Allison, Catarina I Kiefe, Norman W Weissman, Sharina D Person, Matthew Rousculp, John G Canto, Sejong Bae, O Dale Williams, Robert Farmer, Robert M Centor, Relationship of Hospital Teaching Status With Quality of Care and Mortality for Medicare Patients With Acute MI JAMA. ,vol. 284, pp. 1256- 1262 ,(2000) , 10.1001/JAMA.284.10.1256
Kamyar Kalantar-Zadeh, Joel D. Kopple, Ryan D. Kilpatrick, Charles J. McAllister, Christian S. Shinaberger, David W. Gjertson, Sander Greenland, Association of morbid obesity and weight change over time with cardiovascular survival in hemodialysis population. American Journal of Kidney Diseases. ,vol. 46, pp. 489- 500 ,(2005) , 10.1053/J.AJKD.2005.05.020
William E. Mitch, Bradley J. Maroni, Factors causing malnutrition in patients with chronic uremia American Journal of Kidney Diseases. ,vol. 33, pp. 176- 179 ,(1999) , 10.1016/S0272-6386(99)70279-9
Katherine M. Flegal, Barry I. Graubard, David F. Williamson, Mitchell H. Gail, Cause-Specific Excess Deaths Associated With Underweight, Overweight, and Obesity JAMA. ,vol. 298, pp. 2028- 2037 ,(2007) , 10.1001/JAMA.298.17.2028
Andrew S Levey, Juan P Bosch, Julia Breyer Lewis, Tom Greene, Nancy Rogers, David Roth, Modification of Diet in Renal Disease Study Group*, A More Accurate Method To Estimate Glomerular Filtration Rate from Serum Creatinine: A New Prediction Equation Annals of Internal Medicine. ,vol. 130, pp. 461- 470 ,(1999) , 10.7326/0003-4819-130-6-199903160-00002
Kathleen McTigue, Joseph C. Larson, Alice Valoski, Greg Burke, Jane Kotchen, Cora E. Lewis, Marcia L. Stefanick, Linda Van Horn, Lewis Kuller, Mortality and Cardiac and Vascular Outcomes in Extremely Obese Women JAMA. ,vol. 296, pp. 79- 86 ,(2006) , 10.1001/JAMA.296.1.79