PD409 - BODY MASS INDEX AS A SOCIAL MARKER IN HEMODIALYSIS SURVIVAL.

PD409

BODY MASS INDEX AS A SOCIAL MARKER IN HEMODIALYSIS SURVIVAL.

L. Salaroli^1,*, C. A. Martins², L. P. Klippel³, K. S. Barbosa⁴, L. V. Leandro⁴, E. H. Furtado⁵, E. S. Neto¹

¹Postgraduate Program in Public Health, Federal University of Espirito Santo, ²Postgraduate Program in Public Health, ³Postgraduate Program in Nutrition and Health, Federal University of Clinical Nutrition, ⁴Departament of Nutrition, Federal University of Espirito Santo, Vitória, ⁵Departament of Nutrition, Federal Unuversity of Maranhão, Maranhão, Brazil

Rationale: Survival in hemodialysis is not determined solely by clinical factors; in unequal contexts, nutritional status reflects social vulnerabilities ¹. Thus, the study examines the interaction between BMI and social determinants, treating BMI as a structural rather than merely individual indicator.

Methods: We conducted a retrospective cohort study of 953 hemodialysis patients in Brazil, with baseline data from 2019 and mortality follow-up to 2022. Survival was analyzed using Kaplan–Meier curves, with group comparisons by log-rank test. Cox models assessed all-cause and cardiovascular mortality, adjusted for key covariates.

Results: During 36 months of follow-up, 326 deaths occurred; cardiovascular diseases were the leading cause (32.8%). Individuals classified as eutrophic showed the highest survival across adult and older-adult strata, while those with overweight exhibited consistently lower survival probabilities (log-rank p < 0.05). In the adjusted Cox model for cardiovascular mortality, never having smoked was protective (HR 0.62; 95% CI 0.41–0.96), as was ≥11 years of schooling (HR 0.35; 95% CI 0.13–0.89). BMI categories did not retain independent significance after adjustment, indicating that their effect is mediated by social conditions.

Conclusion: Hemodialysis survival rates are influenced by social factors, and nutritional status, measured by BMI, reflects structural inequalities, not only biological risk. Integrated public policies on education, food access, continuity of care, and socioeconomic vulnerability are essential to ensure equitable survival.

References: 1 Ma YX, Wang Y, Chen X, et al. Sociodemographic disparities and mortality among adults with kidney failure: a systematic review and meta-analysis. Clin Med. 2024;13(2):189-201. doi:10.3390/jcm13020189

Disclosure of Interest: None declared