Association of Obesity and Malnutrition with In-Hospital Mortality and Clinical Outcomes in Patients Receiving Maintenance Dialysis: A National Database Study
Issued Date
2026-01-01
Resource Type
eISSN
20726643
Scopus ID
2-s2.0-105027068166
Pubmed ID
41515273
Journal Title
Nutrients
Volume
18
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Nutrients Vol.18 No.1 (2026)
Suggested Citation
Wathanavasin W., Kaewput W., Thongprayoon C., Tangpanithandee S., Suppadungsuk S., Cheungpasitporn W. Association of Obesity and Malnutrition with In-Hospital Mortality and Clinical Outcomes in Patients Receiving Maintenance Dialysis: A National Database Study. Nutrients Vol.18 No.1 (2026). doi:10.3390/nu18010157 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114531
Title
Association of Obesity and Malnutrition with In-Hospital Mortality and Clinical Outcomes in Patients Receiving Maintenance Dialysis: A National Database Study
Corresponding Author(s)
Other Contributor(s)
Abstract
Background/Objectives: The study aimed to investigate whether malnutrition influences the obesity paradox and to explore the relationship between obesity with/without malnutrition and in-hospital outcomes among hospitalized ESKD patients. Methods: The study used the National Inpatient Sample database from 2016 to 2021. Hospitalized ESKD patients were included and categorized into three groups: non-obese, obese without malnutrition, and obese with malnutrition. The association between obesity with/without malnutrition and in-hospital outcomes, compared to non-obese patients, were analyzed. Results: Of 674,367 hospitalized ESKD patients included, 125,978 (18.7%) had obesity. Obese ESKD patients without malnutrition were associated with a decreased risk of mortality (odd ratio [OR] 0.87, 95% CI 0.84–0.91), whereas obese patients with malnutrition were associated with an increased risk of mortality (OR 2.08, 95% CI 1.90–2.27), compared to non-obese patients. Furthermore, obesity, with or without malnutrition, was linked to higher infection-related complications and resource utilization, especially when malnutrition was present. Conclusions: Our findings show that obesity is significantly associated with lower in-hospital mortality among ESKD patients without malnutrition. However, when malnutrition coexists, this survival advantage is reversed, underscoring the importance of detecting malnutrition in obese ESKD patients.