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Health","doi-asserted-by":"crossref","award":["K01DK125616"],"award-info":[{"award-number":["K01DK125616"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Obesity is prevalent in people with CKD and may be a risk factor for developing serious infections.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Among people with CKD, both obesity and underweight were significantly associated with the risk of infection.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>There was a strong association of obesity with skin infection, relative to other infection subtypes, which warrants further investigations.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People with CKD are at high risk of infection, potentially as a result of impaired immune function. Obesity is prevalent in people with CKD and may be a risk factor for developing serious infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In 5499 participants of the Chronic Renal Insufficiency Cohort Study, we examined the association of measures of obesity and body composition with time to first hospitalization with infection, defined by hospital discharge records with a diagnostic code for major infections. Body mass index was categorized as underweight (&lt;18.5 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), normal weight (18.5\u201324.9), overweight (25.0\u201329.9), and class 1 (30.0\u201334.9); class 2 (35.0\u201339.9); and class 3 (\u226540.0) obesity. Measures of body cell mass (\n                      <jats:italic toggle=\"yes\">i.e<\/jats:italic>\n                      ., phase angle) and tissue hydration status (\n                      <jats:italic toggle=\"yes\">i.e<\/jats:italic>\n                      ., vector length), assessed with bioelectrical impedance, were grouped into quartiles. We used multivariable Cox models to estimate adjusted hazard ratios (aHRs) of all-cause infection, as well as by infection subtypes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During follow-up (median, 4.7 years), 2913 participants had hospitalization with infection. Compared with normal weight, class 3 obesity and underweight were both associated with a higher risk of all-cause infection (aHR, 1.35; 95% confidence interval [CI], 1.16 to 1.57 and 1.76; 95% CI, 1.06 to 2.93, respectively). Compared with the highest quartile, the lowest quartiles of phase angle and vector length were significantly associated with a higher risk of all-cause infection (aHR, 1.39; 95% CI, 1.22 to 1.57 and 1.17; 95% CI, 1.02 to 1.33, respectively). When the analysis was separately performed by infection subtypes, the association of obesity was particularly strong for skin and soft tissue infection (aHR, 1.98; 95% CI, 1.54 to 2.54), but not for others (\n                      <jats:italic toggle=\"yes\">e.g<\/jats:italic>\n                      ., aHR for lower respiratory tract infection, 0.96; 95% CI, 0.77 to 1.19), whereas underweight and shallow phase angle were broadly associated with the risk of infection across subtypes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among people with CKD, both obesity and underweight were significantly associated with the risk of infection. The association of obesity with skin infection, relative to other infection subtypes, warrants further investigations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.0000000845","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T16:00:43Z","timestamp":1760976043000},"page":"1706-1717","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Association of Obesity and Body Composition and Hospitalization Risk with Infection in the CRIC Study"],"prefix":"10.2215","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6782-0612","authenticated-orcid":false,"given":"Yefei","family":"Yu","sequence":"first","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"},{"name":"Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1210-7115","authenticated-orcid":false,"given":"Bernard G.","family":"Jaar","sequence":"additional","affiliation":[{"name":"Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"},{"name":"Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4699-5395","authenticated-orcid":false,"given":"Panduranga S.","family":"Rao","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of Michigan Medicine School, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1960-1730","authenticated-orcid":false,"given":"Zeenat","family":"Bhat","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of Michigan Medicine School, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3559-4374","authenticated-orcid":false,"given":"Hernan","family":"Rincon-Choles","sequence":"additional","affiliation":[{"name":"Department of Kidney Medicine, Cleveland Clinic Foundation, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7167-2619","authenticated-orcid":false,"given":"Giselle Rodriguez de","family":"Sosa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8670-3644","authenticated-orcid":false,"given":"Ana C.","family":"Ricardo","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Illinois Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4320-7151","authenticated-orcid":false,"given":"Jonathan","family":"Taliercio","sequence":"additional","affiliation":[{"name":"Department of Kidney Medicine, Cleveland Clinic Foundation, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy Van","family":"Dyke","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9035-9126","authenticated-orcid":false,"given":"Jing","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0673-6823","authenticated-orcid":false,"given":"Lawrence J.","family":"Appel","sequence":"additional","affiliation":[{"name":"Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, 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