Relationship of body size and mortality among US Asians and Pacific Islanders on dialysis

Ethn Dis. Winter 2011;21(1):40-6.

Abstract

Objectives: The influence of body size on dialysis-related mortality among Asians and Pacific Islanders--heterogeneous ethnic groups with dissimilar body compositions--is poorly understood. Our study objective was to compare the relations of body size and mortality among patients with end-stage renal disease of different ethnicities.

Design, setting, and participants: We examined data from a cohort of 21,492 adult Asians, Pacific Islanders and non-Hispanic Whites who initiated dialysis during 1995-2003 within California, Hawaii and the US Pacific Islands.

Main outcome measure: Time to death through September 22, 2008.

Results: Among both men and women, Pacific Islanders were the heaviest and Whites the tallest of the ethnic groups examined. Annual mortality rates were highest among Whites (29.6%), intermediate among Pacific Islanders (18.8%) and lowest among Asians (17.3%). Larger body size was associated with lower mortality among Pacific Islanders, Whites and most Asians on dialysis after adjustment for patient-level sociodemographic and clinical factors, area-based socioeconomic status and geographic clustering. Filipinos were the exception to this rule and showed a trend towards higher mortality with increasing body size. These findings were consistent irrespective of how body size was measured.

Conclusions: Larger body size is associated with lower mortality among Pacific Islanders, Whites and most Asians on dialysis. Use of disaggregated ethnicity data may enhance our understanding of how ethnicity- or community-specific factors influence body size, body composition and dialysis-related outcomes in these diverse populations.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity
  • Adult
  • Asian Americans* / statistics & numerical data
  • Body Size*
  • California / epidemiology
  • Cohort Studies
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Humans
  • Kidney Failure, Chronic / ethnology
  • Kidney Failure, Chronic / mortality*
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Obesity / ethnology
  • Oceanic Ancestry Group* / statistics & numerical data
  • Pacific Islands / epidemiology
  • Proportional Hazards Models
  • Renal Dialysis / mortality*