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KMID : 1102220170360010039
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Kidney Research and Clinical Practice
2017 Volume.36 No. 1 p.39 ~ p.47
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Body mass index is inversely associated with mortality in patients with acute kidney injury undergoing continuous renal replacement therapy
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Kim Hyoung-Nae
Kim Joo-Hwan
Seo Chang-Hwan
Lee Mi-Sol
Cha Min-Uk
Jung Su-Young
Jhee Jong-Hyun
Park Seo-Hyun
Yun Hae-Ryong
Kee Youn-Kyung
Yoon Chang-Yun
Oh Hyung-Jung
Park Jung-Tak
Chang Tae-Ik
Yoo Tae-Hyun
Kang Shin-Wook
Han Seung-Hyeok
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Abstract
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Background: Many epidemiologic studies have reported on the controversial concept of the obesity paradox. The presence of acute kidney injury (AKI) can accelerate energy-consuming processes, particularly in patients requiring continuous renal replacement therapy (CRRT). Thus, we aimed to investigate whether obesity can provide a survival benefit in this highly catabolic condition.
Methods: We conducted an observational study in 212 patients who had undergone CRRT owing to various causes of AKI between 2010 and 2014. The study end point was defined as death that occurred within 30 days after the initiation of CRRT.
Results: Patients were categorized into three groups according to tertiles of body mass index (BMI). During ≥30 days after the initiation of CRRT, 39 patients (57.4%) in the highest tertile died, as compared with 58 patients (78.4%) in the lowest tertile (P = 0.02). In a multivariable analysis adjusted for cofounding factors, the highest tertile of BMI was significantly associated with a decreased risk of death (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.37?0.87; P = 0.01). This significant association remained unaltered for 60-day (HR, 0.64; 95% CI, 0.43?0.94; P = 0.03) and 90-day mortality (HR, 0.66; 95% CI, 0.44?0.97; P = 0.03).
Conclusion: This study showed that a higher BMI confer a survival benefit over a lower BMI in AKI patients undergoing CRRT.
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KEYWORD
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Acute kidney injury, Body mass index, Continuous renal replacement therapy, Mortality, Obesity
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