Research
Energy balance
In advanced CKD and dialysis patients, higher BMI (including morbid obesity) is associated with better survival outcomes, a phenomenon known as the 'obesity paradox'.
If you are on dialysis, do not try to lose weight. Your higher body weight is actually protecting your life. Focus on eating enough protein and calories to maintain your muscle mass, as losing weight is dangerous for dialysis patients.
GoodQualifiesHIGH confidence
A high body mass index (BMI) in advanced CKD stages and dialysis is an advantage for survival (so called 'obesity paradox')... Analysis of death rates in advanced CKD stages suggest that BMI > 40 was not associated with higher risks of death after excluding diabetes and hypertension from the risk model.
Why this rating
Supported by large US cohort studies, single-center studies, and reviews cited.
Source
Preventive Nephrology: The Role of Obesity in Different Stages of Chronic Kidney Disease
Wolfgang Pommer · Kidney Diseases · 2018
DOI 10.1159/000490247
narrative_reviewCited 49×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
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