The effect of body mass index on the development of acute kidney injury and mortality in intensive care unit: is obesity paradox valid?
Renal Failure, cilt.43, sa.1, ss.543-555, 2021 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 43 Sayı: 1
- Basım Tarihi: 2021
- Doi Numarası: 10.1080/0886022x.2021.1901738
- Dergi Adı: Renal Failure
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database, Directory of Open Access Journals
- Sayfa Sayıları: ss.543-555
- Anahtar Kelimeler: Acute kidney injury, body mass index, obesity, mortality, intensive care unit, obesity paradox, mechanical ventilation
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: The conflicting results of studies on intensive care unit (ICU) mortality of obese patients and obese patients with acute kidney injury (AKI) reveal a paradox within a paradox. The aim of this study was to determine the effects of body mass index and obesity on AKI development and ICU mortality. Methods: The 4,459 patients treated between January 2015 and December 2019 in the ICU at a Tertiary Care Center in Turkey were analyzed retrospectively. Results: AKI developed more in obese patients with 69.8% (620). AKI development rates were similar in normal-weight (65.1%; 1172) and overweight patients (64.9%; 1149). The development of AKI in patients who presented with cerebrovascular diseases was higher in obese patients (81; 76.4%) than in normal-weight (158; 62.7%) and overweight (174; 60.8%) patients (p < 0.05). The risk of developing AKI was approximately 1.4 times (CI 95% = 1.177–1.662) higher in obese patients than in normal-weight patients. Dialysis was used more frequently in obese patients (24.3%, p < 0.001), who stayed longer in the ICU (p < 0.05). It was determined that the development of AKI in normal-weight and overweight patients increased mortality (p < 0.001) and that there was not a difference in mortality rates between obese patients with and without AKI. Conclusion: The risk of AKI development was higher in obese patients but not in those who were in serious conditions. Another paradox was that the development of AKI was associated with a higher mortality rate in normal-weight and overweight patients, but not in obese patients. Cerebrovascular diseases as a cause of admission pose additional risks for AKI.