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. 2020 Oct 6:11:534294.
doi: 10.3389/fendo.2020.534294. eCollection 2020.

The Association Between Obesity and Risk of Acute Kidney Injury After Cardiac Surgery

Ning Shi  1   2 , Kang Liu  3 , Yuanming Fan  1   2 , Lulu Yang  1   2 , Song Zhang  1   2 , Xu Li  1   2 , Hanzhang Wu  3 , Meiyuan Li  3 , Huijuan Mao  3 , Xueqiang Xu  3 , Shi-Ping Ma  2 , Pingxi Xiao  4 , Shujun Jiang  1   5
Affiliations

The Association Between Obesity and Risk of Acute Kidney Injury After Cardiac Surgery

Ning Shi et al. Front Endocrinol (Lausanne). .

Abstract

Objective: To determine the relationship between obesity and the risk of AKI after cardiac surgery (CS-AKI) in a cohort study.

Methods: A total of 1,601 patients undergoing cardiac surgery were collected and their incidence of CS-AKI was recorded. They were divided into underweight, normal weight, overweight, and obese groups. Logistic regression was used to estimate the association between BMI (body mass index) and CS-AKI risk. Then, a meta-analysis of published cohort studies was conducted to confirm this result using PubMed and Embase databases.

Results: A significant association was observed in this independent cohort after adjusting age, gender, hypertension and New York Heart Association classification (NYHA) class. Compared with normal BMI group (18.5 ≤ BMI < 24.0), the individuals with aberrant BMI level had an increased AKI risk (OR: 1.68, 95% CI: 1.01-2.78) for BMI < 18.5 group and (OR: 1.43, 95% CI: 0.96-2.15) for BMI ≥ 28.0. Interestingly, the U-shape curve showed the CS-AKI risk reduced with the increasing of BMI when BMI ≤ 24.0. As BMI increases with BMI > 24.0, the risk of developing CS-AKI increased significantly. In the confirmed meta-analysis, compared with normal weight, overweight group with cardiac surgery had higher AKI risk (OR: 1.28, 95% CI: 1.16-1.41, Pheterogeneity = 0.49). The similar association was found in obesity subgroup (OR: 1.79, 95% CI: 1.57-2.03, Pheterogeneity = 0.42).

Conclusion: In conclusion, the results suggested that abnormal BMI was a risk factor for CS-AKI independently.

Keywords: acute kidney injury; body mass index; cardiac surgery; creatinine; obesity.

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Figures

Figure 1
Figure 1
The linear relationship between BMI and AKI. The short black vertical line respect different BMI of individuals. The red solid line and the dash line respect the estimated relative risk and its 95% CI.
Figure 2
Figure 2
(A) Forest plot of ORs of obesity vs. normal weight and (B) forest plot of ORs of overweight vs. normal weight. Black squares indicate the OR in each study, horizontal lines represent the 95% CI. OR, odd ratio; CI, confidence interval; BMI, body mass index.
See this image and copyright information in PMC

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