Mortality in patients with 5D chronic kidney disease associated with obesity.

A narrative review.

Abstract

Introduction: The Rico-Fontalvo classification of chronic kidney disease associated with obesity (CKD-AO) proposes four main pathophysiological mechanisms of renal function impairment with obesity. Type 4 CKD-OA addresses the issue of obesity in patients undergoing dialysis programs. An increase in body mass index > 30 kg/m² in the general population is associated with a higher risk of developing cardiovascular and metabolic diseases and higher mortality. In the group of patients undergoing hemodialysis therapies, the opposite occurs.

The objective of the review: The aim is to provide the reader with an update on the effect of weight, body composition, and body mass index in patients undergoing hemodialysis therapy in the short, medium, and long term.

Methods: A systematic search was performed in PubMed (Medline, United States Library of Congress); the search was restricted to references with no publication date limit. Keywords in English were used.

Conclusion: The increase in body mass index >25 Kg/m² in the population group of patients undergoing hemodialysis treatments has a protective effect, decreasing mortality in studies carried out with 3 to 5 years of follow-up; At a longer follow-up time (12 years), according to observational studies, an increase in body mass index >30 kg/m² seems to have a harmful effect equal to that of the general population. The benefit of an increase in BMI >25 kg/m² and a decrease in mortality is more significant in men, African Americans, Hispanics, and those over 65.