Format

Send to

Choose Destination
PLoS One. 2018 Nov 29;13(11):e0208258. doi: 10.1371/journal.pone.0208258. eCollection 2018.

Short-term prognosis of emergently hospitalized dialysis-independent chronic kidney disease patients: A nationwide retrospective cohort study in Japan.

Author information

1
Department of Nephrology, Graduate School of Medicine and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
2
Medical Science, Kawasaki Medical School, Okayama, Japan.
3
Department of Health Policy and Informatics, Graduate School of Medicine and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Abstract

In patients with chronic kidney disease (CKD), low body mass index (BMI) is associated with high mortality. This relationship in emergently hospitalized CKD patients is unknown. We investigated the association between obesity and short-term mortality in emergently admitted patients with dialysis-independent CKD (DI-CKD) with and without infection. This retrospective cohort study examined Diagnosis Procedure Combination data of 26103 emergently hospitalized DI-CKD patients. Patients were divided into 8 groups according to their BMI and the presence of infectious diseases. The primary outcome was in-hospital death within 100 days. Cox proportional hazards models adjusted for baseline characteristics showed that low BMI was associated with the outcome both in infected and in non-infected patients (reference group as non-infected and medium BMI [24-26 kg/m2] group): infected and the lowest BMI (≤20 kg/m2) group, hazard ratio (HR) 1.82 (95% confidence interval 1.51, 2.19); non-infected and the lowest BMI group, 1.39 (1.16, 1.67). When patients were stratified according to presence of diabetes mellitus (DM), patients with DM showed that low BMI was associated with the outcome both in infected and in non-infected patients, whereas in non-DM patients, this relationship was attenuated in the non-infected group. For emergently hospitalized CKD patients with infection, high BMI was associated with lower mortality irrespective of the DM status. For non-infected patients, the effects of obesity for in-hospital mortality were modified by the DM status.

Conflict of interest statement

The authors have declared that no competing interests exist.

Supplemental Content

Full text links

Icon for Public Library of Science Icon for PubMed Central
Loading ...
Support Center