FIGURE 4.

Change in serum creatinine concentration (a surrogate of change in muscle mass) during the first 6 months of the cohort as a predictor of mortality in 58,201 patients receiving hemodialysis (HD) who survived through the first 2 calendar quarters of the cohort and for whom pre-HD serum creatinine values for the 6 consecutive months were available. Compared with patients with stable serum creatinine concentrations (dry weight gain or loss of <1%), patients with a graded decline in dry weight had an increased risk of subsequent death, whereas weight gain during the 6 months was incrementally associated with greater 5-year survival. An increase or decrease in serum creatinine levels during the first 6 months was associated with parallel changes in subsequent survival in the entire cohort. Cox regression–based hazard ratios of death are represented by unfilled circles for the unadjusted model, filled circles for the model adjusted for case mix, and unfilled triangles for models adjusted for case mix and the malnutrition-inflammation-cachexia syndrome (MICS). Error bars represent 95% confidence intervals. See legend of Figure 1 for the list of covariates in multivariate adjustment.