Obesity, acute kidney injury and mortality in patients with sepsis: a cohort analysis

Abstract

Although the prognostic effect of obesity has been studied in critically ill patients its impact on outcomes of septic patients and its role as a risk factor for acute kidney injury (AKI) is not consensual. We aimed to analyze the impact of obesity on the occurrence of AKI and on in-hospital mortality in a cohort of critically ill septic patients. This study is retrospective including 456 adult patients with sepsis admitted to the Division of Intensive Medicine of the Centro Hospitalar Lisboa Norte (Lisbon, Portugal) between January 2008 and December 2014. Obesity was defined as a body mass index of 30 kg/m2 or higher. The Kidney Disease Improving Global Outcomes classification was used to diagnose and classify patients developing AKI. AKI occurred in 87.5% of patients (19.5% with stage 1, 22.6% with stage 2 and 45.4% with stage 3). Obese patients developed AKI more frequently than non-obese patients (92.8% versus 85.5%, p = .035; unadjusted OR 2.2 (95% CI: 1.04–4.6), p = .039; adjusted OR 2.31 (95% CI: 1.07–5.02), p = .034). The percentage of obese patients, however, did not differ between AKI stages (stage 1, 25.1%; stage 2, 28.6%; stage 3, 15.4%; p = .145). There was no association between obesity and mortality (p = .739). Of note, when comparing AKI patients with or without obesity in terms of in-hospital mortality there were also no significant differences between those groups (38.4% versus 38.4%, p = .998). Obesity was associated with the occurrence of AKI in critically ill patients with sepsis; however, it was not associated with in-hospital mortality.

MiR-21-3p Plays a Crucial Role in Metabolism Alteration of Renal Tubular Epithelial Cells during Sepsis Associated Acute Kidney Injury via AKT/CDK2-FOXO1 Pathway

“…The kidney is one of the most vulnerable organs in sepsis and sepsis associated acute kidney injury (SAKI) is determined to be closely related to poor prognosis and progress to chronic kidney disease (CKD) [5][6][7][8]. Renal tubular epithelial cell (TEC) acts as a central role in the occurrence and development of SAKI [9][10][11].…”

Higher body mass index is not a protective risk factor for 28-days mortality in critically ill patients with acute kidney injury undergoing continuous renal replacement therapy

“…There several studies that had shown that the following factors: age, platelet count, APACHE II score, serum creatinine level, a urine output of <0.05 mL/kg/h the first day, eGFR <45 mL/min, et al were associated with the prognosis of patients with AKI undergoing CRRT [18,19]. Moreover, there was study that reported that BMI was a risk for AKI, but was not associated with prognosis of the patients with sepsis treated with CRRT [20].…”

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