Incidence of major cardiovascular events at 1, 2, and 5 years and mortality in incident patients on peritoneal dialysis regarding their nutritional status by bioimpedanciometry: A multicenter study in Colombia.

BACKGROUND: The nutritional status of incident patients on peritoneal dialysis (PD) has been associated with survival outcomes. Bioimpedanciometry (BCM) enables to establish a nutritional diagnosis, the volume status, and correlates these findings with survival. METHODS: This study used a retrospective multicenter historical cohort. RESULTS: In this study, which included 420 incident patients on peritoneal dialysis with a 5-year follow-up, a cumulative incidence of major adverse cardiovascular events (MACE) of 28.8% was found, being higher in the diabetic population at 36.8%. In regard to the nutritional status in this population, it was found that approximately 44% had altered nutritional status; 34% were found to be in sarcopenia; 6.7% sarcopenic obesity; and 2.8% in obesity (p < 0.001). In the survival analysis, a lower probability of survival was found in patients with overhydration (OH) greater than 3 L (p < 0.001) and in patients with altered nutritional status due to sarcopenia, sarcopenic obesity, and obesity (p 0.016). According to survival in the subgroup of the diabetic population, a lower probability of survival was found in this group of patients (p: 0.011). The overall mortality of the study population was 18%, being higher in the first 2 years, with the most important causes of mortality being cardiovascular. Of the deceased population, 51% were diabetic patients (p: 0.012). CONCLUSION: In incident patients on peritoneal dialysis, sarcopenic obesity, sarcopenia, overhydration status determined by BCM, and having a diagnosis of diabetes are related to a lower probability of survival; MACE outcomes are more frequent in the diabetic population.

Response of antibody titers to SARS-CoV-2 vaccination and clinical outcomes during the predominance of the Omicron variant in Colombia.

Introduction: The response to vaccination against the virus that causes severe acute respiratory infection syndrome coronavirus 2 is lower in renal transplant recipients than in the general population. The data obtained from Latin America showed reduced immunogenicity under inactivated virus vaccination schedules and messenger ribonucleic acid platforms. Methods: A retrospective cohort study including renal transplant recipients from Colombia with a two-dose vaccination schedule against severe acute respiratory infection syndrome coronavirus 2 with Pfizer, AstraZeneca, Moderna, Jansen, and Sinovac vaccines between March 1, 2021 and December 1, 2021, was carried out with a follow-up period to evaluate outcomes until May 2022. The outcomes correspond to the titers of immunoglobulin G antibodies against the receptor binding domain of the severe acute respiratory infection syndrome coronavirus 2 spike and a composite outcome of mortality, general, and intensive care unit hospitalization. Results: In total, 215 renal transplant recipients with two doses of vaccination for severe acute respiratory infection syndrome coronavirus 2 during the predominance of the Omicron variant in Colombia were included, with the measurement of immunoglobulin G antibody titers against the receptor binding domain of the severe acute respiratory infection syndrome coronavirus 2 spike at 8 weeks of vaccination. The mean age was 52.1 years, and the standard deviation was ± 14.2; severe acute respiratory infection syndrome coronavirus 2 infection occurred in 20% of the population, of which 23.26% required hospitalization, 13.95% were under intensive care unit management, and four cases of mortality (9.3%) were reported. Of the total population, 52.5% had antibody titers higher than 0.8 IU/mL (median 0.77 IU/mL, interquartile range 0.4-131). Patients with severe acute respiratory infection syndrome coronavirus 2 infection had a median antibody titer of 0.4 IU/mL (interquartile range 0.4-3.45), and those without infection had a median antibody titer of 1.8 IU/mL (interquartile range 0.4-202) (p = 0.015). Conclusion: Anti-severe acute respiratory infection syndrome coronavirus 2 antibody titers with a cutoff point less than 0.8 IU/mL are associated with increased risk of severe acute respiratory infection syndrome coronavirus 2 infection.