Body Mass Index Paradox in Hemodialysis Patients: A Review

Among population, the higher the body mass index (BMI), it would increase the risk of chronic illness and as a result, the risk of mortality. But this does not happen in the population of hemodialysis patients, so the risk of mortality decreases with increasing BMI.This paradox is attributed to a variety of factors including blood pressure, inflammation, and muscular mass; that is, in moderate hemodialysis patients, the blood pressure would be higher and therefore, its control would be less. In addition, the higher the BMI, the greater would be the muscular mass in these patients which is likely to increase the survival of them. Patients with a higher BMI would also experience more nutritional reserves and therefore their tolerance for inflammation would be higher. Although an increase in BMI reduces the risk of mortality in these patients, an increase in muscular mass would be better than an increase in body fat mass.