Relationship Between Nutritional Status and Mortality in Adults on Maintenance Haemodialysis - A Meta-Analysis

Abstract

The aim of this systematic review was to determine the strength and direction of the association between body mass index (BMI), subjective global assessment (SGA) and mortality in adult patients on maintenance haemodialysis. Electronic data sources included Medline, Science Citation Index, Academic Search Premier, the Cochrane Library and Embase for the period 1963–2008. Data extraction and quality assessment were done by two independent reviewers. During meta-analysis of 12 studies reporting on BMI and four studies reporting on SGA results were pooled using the random effects model. Cochran’s Q was used to identify heterogeneity. Higher levels of BMI were associated with a weak but significant reduction in overall mortality (log HR -0.0413, CI -0.0588 to -0.0237) with no significant difference between all-cause and cardiovascular mortality (p = 0.4197). The relationship between mortality and SGA was also not significant (log HR 0.0643, CI -0.1713 to 0.2999). A high degree of heterogeneity was found for both BMI and SGA. In conclusion, BMI showed a weak but significant inverse relationship with all-cause and cardiovascular mortality but the meta-analysis failed to confirm a significant relationship between SGA and mortality.