Body Mass Index and Risk for End-Stage Renal Disease

Micah L. Thorp

doi:10.7326/0003-4819-144-9-200605020-00020

Letters |2 May 2006

Body Mass Index and Risk for End-Stage Renal Disease

Micah L. Thorp, DO, MPH

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TO THE EDITOR:

Hsu and colleagues (1) found a significant correlation between body mass index (BMI) and subsequent renal replacement therapy. Perhaps because of the generous sample size, lengthy follow-up, or survival bias, the relationship was more substantial than previously reported. This finding provides an important insight in determining the significance of BMI in the development of renal disease, a relationship that is both complex and not yet fully understood.

Although increased BMI may be associated with the development of renal disease (and subsequent renal replacement therapy), it is an association that may change throughout disease progression. Studies examining risk factors for progression of renal disease and mortality among patients with established chronic kidney disease (CKD) have found modest or no correlations between outcome and BMI (2, 3). After patients require renal replacement therapy, increased BMI is associated with increased survival (4). This phenomenon has been referred to as “reverse epidemiology” or “the dialysis–risk paradox” (5).

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2006 American College of Physicians

Letters |2 May 2006

Body Mass Index and Risk for End-Stage Renal Disease

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Letters |2 May 2006

Body Mass Index and Risk for End-Stage Renal Disease

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