Abstract: 【Abstract】Objective To investigate the relationship between lean body mass (LBM) and risk of mortality in maintenance hemodialysis (MHD) patients. Methods We retrospectively analyzed the MHD patients treated in the Dialysis Center, Tianjin Union Medical Center and matched the research criteria. Their
LBM and others parameters were collected. A validated creatinine-based formula, LBM(kg)=0.34×serum creatinine (mg/dl)+5.58×gender (1 for female and 0 for male)+0.30×body weight(kg)+0.67×body height (inch)-0.23×URR (urea reduction ratio)-5.75(linch=0.1254m), was used to estimate LBM. The relationship between LBM and risk of mortality was then assessed. Results This cohort enrolled 187 MHD patients. Higher LBM was related to younger age (H=3.273, P=0.049), male (χ2=4.174, P=0.041), higher body weight (F=6.438, P=0.027) and body mass index(BMI)(F=5.997,P=0.029), higher serum albumin (F=3.811, P=0.043), creatinine(F=4.778,P=0.031), phosphorus(F=3.766,P=0.044) and intact parathyroid hormone(iPTH) (F=3.498, P=0.047). We divided the patients into 5 groups based on the 20th percentile of LBM values (＜36.3, 36.3～40.7,40.7～44.9,44.9～49. 4and＞49.4 kg). Patients in the 40.7～44.9 kg group was used as the reference group. After adjustment by multiple factors, we found that higher LBM was associated with lower mortality. Compared to the reference group, the risk of mortality increased by 31% in the lowest LBM group (HR: 1.31, 95% CI 1.11-1.53, P=0.043), while the risk decreased by 15% in the highest LBM group (HR: 0.85, 95% CI 0.72-0.95, P=0.038). Conclusions In MHD patients, higher LBM was associated with lower risk of mortality. We therefore have the possibility to predict risk of mortality by LBM in MHD patients.

Key words: hemodialysis, lean body mass, body mass index, mortality, nutrition