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. 

Key words: Maintenance hemodialysis, Sarcopenia, Body cell mass index, Bioelectrical impedance;Prognosis