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ABSTRACT
Background In the general population with COVID-19, obesity is associated with an increased risk of mortality. Given the typically observed obesity paradox among patients on kidney function replacement therapy (KFRT), especially dialysis patients, we examined the association of obesity with mortality among dialysis patients or living with a kidney transplant with COVID-19. Methods Data from the European Renal Association COVID-19 Database (ERACODA) were used. KFRT-patients diagnosed with COVID-19 between February 1st, 2020, and January 31st, 2021 were included. The association of Quetelet's body mass index (BMI) (kg/m2), divided into <18.5 (lean), 18.5-24.9 (normal weight), 25-29.9 (overweight), 30-34.9 (obese I) and ≥35 (obese II/III), with 3-month mortality was investigated using Cox proportional-hazards regression analyses. Results In 3,160 patients on KFRT (mean age65 years, male61%), 99 patients were lean, 1,151 normal weight (reference), 1,160 overweight, 525 obese I, and 225 obese II/III. During follow-up of 3 months, 28%, 20%, 21%, 23%, and 27% of patients died in these categories, respectively. In the fully adjusted model, the HRs for 3-month mortality were 1.65 (95%CI1.10,2.47), 1 (ref.), 1.07 (95%CI0.89,1.28), 1.17 (95%CI0.93,1.46) and 1.71 (95%CI1.27,2.30), respectively. Results were similar among dialysis patients (N = 2,343) and among those living with a kidney transplant (N = 817) (pinteraction = 0.99), but differed by sex (pinteraction = 0.019). In males, the HRs for the association of aforementioned BMI categories with 3-month mortality were 2.07 (95% CI1.22, 3.52), 1 (Ref.), 0.97 (95% CI 0.78. 1.21), 0.99 (95% CI 0.74, 1.33) and 1.22 (95%CI0.78, 1.91) respectively, and in females corresponding HRs were 1.34 (95% CI 0.70, 2.57), 1 (Ref.), 1.31 (95% CI 0.94, 1.85), 1.54 (95% CI 1.05, 2.26) and 2.49 (95%CI1.62, 3.84) respectively.”. Conclusion In KFRT-patients with COVID-19, on dialysis or a kidney transplant, obesity is associated with an increased risk of mortality at 3 months. This is in contrast to the obesity paradox generally observed in dialysis patients. Additional studies are required to corroborate the sex difference in the association of obesity with mortality.
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Collection: Databases of international organizations Database: EuropePMC Language: English Journal: Clinical kidney journal Year: 2022 Document Type: Article

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Collection: Databases of international organizations Database: EuropePMC Language: English Journal: Clinical kidney journal Year: 2022 Document Type: Article