Reverse Epidemiolgy

Reverse epidemiolgy according go Wikipedia is "a term for a medical hypothesis which holds that obesity and high cholesterol may, counterintuitively, be protective and associated with greater survival than certain groups of people." This would be like saying, people with class I obesity with heart disease do not have a greater risk than people of normal weight who also have heart disease.

Dr Kamyar Kalantar-Zadeh, MD, PhD is leading a group of researches at the University of California on this contoversial theory. They are also comparing their studies with dialysis patients. For many years poor survival rates in dialysis patients were based on the presence of traditional CVD risk factors (high blood pressure and obesity). Studies they have been doing, however, have actually failed to show this. Some of their research showed that high BMI and high serum albumin and lipid levels are consistently associated with better survival.

Most of their studies have been observational, but a few have been interventional. For instance, one in Germany done a couple years ago showed that dialysis patients who took statins received no survival benefit at four years' follow up compared with patients who received placebos. Dr Kalantar continued on speaking on about patients and their ability for transplants, and how these patients should be cared for (lower BP? loose weight??).

I found this article interesting because this is something we normally don't think about. We always associate obesity and high blood pressure as two bad and harmful things to our bodies. There is more being done in this study comparing their ability for transplants, etc. and should definitely get some attention.

Eva Szabuniewicz
VTPP 435-501

http://www.renalandurologynews.com/reverse-epidemiology-dialysis-paradox/article/20532/