2044

Obesity in the Scottish haemodialysis population: a growing problem?

Reed S1, Ferenbach H1, Traynor JP2, Metcalfe W2 on behalf of the Scottish Renal Registry.
1 Dietetic Department, Renal Unit, Royal Infirmary of Edinburgh
2 Scottish Renal Registry

Introduction
The Scottish health survey reports adult obesity in Scotland to have risen from 17% of those aged 16-64 years in 1995 up to 27% in 2010. In 2010 65% of adults were overweight (BMI ≥25 kg/m2) with 28% of these individuals in the obese category (BMI ≥30 kg/m2). We sought to determine the prevalence of obesity in patients in receipt of haemodialysis in Scotland in the five years 2009-2013.

Methods
The Scottish Renal Registry (SRR) performs an annual census each May to collect crosssectional data for all prevalent haemodialysis patients in Scotland. Data items include height and weight on the census day which allows calculation of body mass index (BMI). Primary renal diagnosis (PRD) was grouped into interstitial disease, glomerulonephritis, multisystem disease, diabetic nephropathy and unknown cause. Patients were grouped by age on the census day into 18-64years, 65-74 years and ≥ 75 years. In 2012 and 2013 the census also records the presence of a lower limb amputation; those patients (n=171) are excluded from the analysis as are patients aged under 18 years on each census date (n=28).

Results
The number of patients in receipt of haemodialysis on the census date of the years 2009-2013 were 1840, 1863, 1874, 1782, 1793 patients respectively with the exclusions noted above.
A BMI was available for 8178 (89.4%) of census records with no significant difference in the number of missing values between years. There was no significant difference in median BMI in each census year ranging from 25.6 – 25.9 kg/ m2. The census BMIs were distributed overall 10.4% BMI <20; 33.7 % BMI 20-24; 31% BMI 25-29; 20.3% BMI 30-40 and 4.5% BMI>40. There was no difference between years in the distribution; overall 55.8% of census records were overweight or obese.
Younger age group was associated with lower BMI grouping [p<0.001 chi-square]. There were significant differences in BMI according to primary renal diagnosis group with 67.5% of those with diabetic nephropathy having BMI ≥ 25 kg/ m2 and 37% ≥ 30 kg/ m2 compared with 46.1% of patients with GN have census BMI ≥ 25 kg/ m2.
1747 (19.1%) census records were within the first year of starting RRT, when just those patients were studied again there was no evidence of a trend of increasing obesity, in those patients new to RRT, over the 5 years studied.

Conclusion
Patients treated with haemodialysis in Scotland reflect the general population propensity to obesity. There is no evidence from our analysis of a trend to increasing obesity in patients receiving haemodialysis in Scotlandover the past five years.