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Preparing your E-Poster
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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Abstract titles should be brief and reflect the content of the abstract.
Nutritional markers are known to influence mortality in patients undergoing haemodialysis (HD); however, these effects likely vary depending on patient characteristics. Although age and HD duration are fundamental and easily accessible clinical factors, their modifying effects on the association between nutritional markers and outcomes have not been sufficiently investigated. We aimed to explore how age and HD duration modify the associations between nutritional markers and all-cause mortality in HD patients.
This post hoc analysis was based on the OCTOPUS study (Olmesartan Clinical Trial in Okinawan Patients under the OKIDS study), a randomized controlled trial conducted between 2006 and 2011, with extended follow-up through 2018. Participants were stratified into tertiles by age and by HD duration. We examined trends in hazard ratios (HRs) and population attributable fractions (PAFs) across these strata. Nutritional markers related to overnutrition (serum phosphate ≥6.0 mg/dL, total cholesterol >200 mg/dL, LDL cholesterol ≥100 mg/dL, HDL cholesterol ≤40 mg/dL, triglycerides >150 mg/dL) and undernutrition (serum albumin <3.5 g/dL, total cholesterol <150 mg/dL, triglycerides <100 mg/dL, LDL cholesterol <70 mg/dL, serum potassium <3.5 mEq/L, BMI <20 kg/m²) were evaluated separately after adjustment for age, sex, and HD duration. Interactions between age and HD duration on the association between each nutritional marker and all-cause mortality were visualized using heatmaps.
A total of 461 patients were analyzed, among whom 211 died during a median follow-up of 10.2 years. Among overnutrition markers, higher serum phosphate and LDL cholesterol were associated with increased mortality risk, particularly in younger patients, while HD duration did not show consistent modification of these effects. Among undernutrition markers, hypoalbuminemia increased mortality risk in most subgroups, except for younger and shorter-duration HD patients, whereas hypokalemia was consistently associated with lower mortality.
Interaction analyses revealed that (1) high serum phosphate (≥6.0 mg/dL) was a significant risk factor among younger and longer-duration HD patients (Figure 1-1); (2) high LDL and low HDL cholesterol were risk factors among younger and shorter-duration HD patients (Figure 1-1); (3) a quantitative positive interaction was observed for hypoalbuminemia (Figure 1-2); and (4) a qualitative interaction was observed for hypokalemia (Figure 1-2).
Stratification by age and HD duration clarified distinct patterns in the associations between nutritional markers and all-cause mortality. Simultaneous grouping by both factors further enhanced the differentiation of these effects. The observed effect modifications for serum phosphate, cholesterol, albumin, and potassium highlight the importance of tailoring nutritional assessment and interventions according to patients’ age and HD duration.
