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Abstract: PO0020

Association Between BMI and Risk of AKI in Hospitalized Patients with COVID-19

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Cavin, Natalia, Jacobi Medical Center, Bronx, New York, United States
  • Santana De Roberts, Rosalba Y., Jacobi Medical Center, Bronx, New York, United States
  • Li, Tianying, Jacobi Medical Center, Bronx, New York, United States
  • Jim, Belinda, Jacobi Medical Center, Bronx, New York, United States
  • Anis, Kisra, Jacobi Medical Center, Bronx, New York, United States
  • Varma, Nidhi, Jacobi Medical Center, Bronx, New York, United States
  • Ansari, Naheed, Jacobi Medical Center, Bronx, New York, United States
  • Acharya, Anjali, Jacobi Medical Center, Bronx, New York, United States
Background

Acute Kidney Injury (AKI) is a frequent complication in ICU patients with a negative impact on patient outcomes. High body mass index (BMI) is reported to be associated with a higher risk of AKI in critically ill patients. Obesity is also a risk factor for developing COVID-19 and for severe illness requiring hospital admission, mechanical ventilation and is associated with mortality

Methods

A multi-center retrospective cohort study was conducted on2,716 electronic health records (EHR), (n=1,719 in first surge dates of 3/1/20 until 7/16/20), (n=997 in second surge dates of 10/15/20 until 2/28/21 with COVID-19. Patients without a recorded BMI value were excluded. AKI at admission was defined as the difference between first measured creatinine and nadir creatinine within the first 7 days of admission that was greater than 0.3 mg/dL[JB1] . The Chi-squared test was used to compare BMI as a categorical variable between AKI and non-AKI groups at admission. The Mann–Whitney U test was used for the same comparison when BMI was treated as a continuous variable. A p-value less than 0.05 is considered statistically significant.

Results

BMI was dichotomized to < 25kg/m2 and >= 25 kg/m2. The non-AKI group had a significantly higher percent of patients with BMI greater or equal to 25 kg/m2 (80.2% vs. 73.7%, p = 0.0108). BMI was not found to be associated with either peak CRP or peak D-Dimer among AKI patients in both surges.

Conclusion

A direct relationship between BMI and AKI is well known, mostly from data that included surgical patients with multiple comorbidities and did not account for peri operative stress[JB1] . The proinflammatory state in obesity may lead to endothelial damage. In CKD and ESRD, obesity is paradoxically associated with a better prognosis. Few studies have shown an inverse relationship between BMI and AKI risk. High levels of lipoproteins in obesity is thought to lead to endothelial protection in the kidney vasculature. A ‘pre-conditioning’ effect of obesity attenuating against abrupt bursts of hyper-inflammation on renal vasculature has been shown. Altered adipokine and cytokine profiles produced by adipose tissue can exert protective effects by decreasing inflammation. We describe here the first study showing an inverse relationship between BMI and developing AKI at hospital admission in COVID-19.