Impact of obesity on in-hospital outcomes in peritoneal dialysis patients: insights from a nationwide analysis
Issued Date
2025-01-01
Resource Type
ISSN
03011623
eISSN
15732584
Scopus ID
2-s2.0-85219601009
Journal Title
International Urology and Nephrology
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Urology and Nephrology (2025)
Suggested Citation
Kaewput W., Thongprayoon C., Suppadungsuk S., Tangpanithandee S., Wathanavasin W., Qureshi F., Cheungpasitporn W. Impact of obesity on in-hospital outcomes in peritoneal dialysis patients: insights from a nationwide analysis. International Urology and Nephrology (2025). doi:10.1007/s11255-025-04438-w Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/106655
Title
Impact of obesity on in-hospital outcomes in peritoneal dialysis patients: insights from a nationwide analysis
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Obesity is a growing public health concern and may influence outcomes in end-stage kidney disease (ESKD) patients undergoing peritoneal dialysis (PD). However, its impact on in-hospital complications, mortality, and healthcare utilization in this population remains unclear. This study aimed to assess the association between obesity and hospitalization-related outcomes in PD patients. Methods: This study was conducted using the National Inpatient Sample to identify hospitalized ESKD patients receiving PD from the year 2003 to 2018. The in-hospital treatments, outcomes, and resource utilization were compared between obese and non-obese patients, adjusting for age, sex, race, year of hospitalization, and comorbidities. Results: A total of 100,523 hospitalized ESKD patients receiving PD were included in the analysis. Of these, 9890 (9.8%) had obesity diagnosis. In the adjusted analysis, obese patients had a higher need for procedures for PD catheter adjustment or removal (OR 1.29; 95% CI 1.16–1.43), hemodialysis (OR 1.28; 95% CI 1.19–1.38), and mechanical ventilation (OR 1.29; 95% CI 1.16–1.44), compared to non-obese patients. Obesity was significantly associated with higher risk of PD peritonitis (OR 1.12; 95% CI 1.06–1.19) and fluid overload (OR 1.34; 95% CI 1.23–1.45) but lower in-hospital mortality (OR 0.84; 95% CI 0.73–0.96). There was no significant difference in length of hospital stay and hospitalization cost between obese and non-obese patients. Conclusion: Among hospitalized PD patients, obesity is associated with higher PD-related complications and increased need for interventions but is paradoxically linked to lower in-hospital mortality. These findings provide new insights into the obesity paradox in PD and highlight the need for tailored management strategies to mitigate obesity-related risks in hospitalized PD patients.