Abstract: FR-PO131
Association Between Body Mass Index and Clinical Outcomes in Patients with AKI Requiring Continuous Renal Replacement Therapy
Session Information
- AKI: Outcomes, RRT
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Kim, Hyung Duk, Catholic University of Korea Eunpyeong St Mary's Hospital, Eunpyeong-gu, Seoul, Korea (the Republic of)
- Kim, Yaeni, Seoul Saint Mary's Hospital, Seocho-gu, Seoul, Korea (the Republic of)
Background
Obesity is associated with higher mortality in general population. However, there has been controversy over the effect of obesity in critically ill patients. In this study, we retrospectively reviewed medical records to investigate the association between body mass index (BMI) and mortality or ESRD incidence in critically ill patients who admitted to intensive care unit (ICU) and receiving continuous renal replacement therapy (CRRT).
Methods
A total of 891 adult patients were admitted to the ICU and received CRRT at three institutions of the Catholic Medical Center from July 2012 to December 2020. Of these patients, 845 subjects were eligible for the study, excluding patients without BMI data or patients with extracorporeal membrane oxygenation (ECMO) treatment. Patients were categorized into 4 groups according to the BMI criteria of the Korean Society for The Study of Obesity (BMI less than 18.5, 18.5-22.9, 23.0-24.9, 25.0kg/m2 or greater). The association between BMI and 1-year overall mortality and 1-year ESRD incidence were investigated.
Results
The 1-year mortality was 43.3%, 47.9%, 36.2% and 39.0% in the underweight, normal, overweight, and obese groups respectively. The mortality rate of obese patients was significantly lower than that of normal patients in Kaplan-Meier analysis (p=0.002). Multivariable logistic regression analysis showed that obese patients had a lower risk of mortality than normal group (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.42-0.85; P=0.005). The 1-year ESRD incidence was 43.6%, 37.9%, 32.4% and 25.0% in the underweight, normal, overweight, and obese groups respectively. In a multivariable logistic regression analysis adjusted for confounding factors, obesity was associated with a decreased risk of ESRD (HR, 0.56; 95% CI, 0.34-0.92; P=0.023). In subgroup analysis according to age, 1-year mortality consistently showed an inverse correlation between BMI and mortality, but ESRD incidence was inversely related with obesity only in patients with age > 65.
Conclusion
In critically ill patients admitted to ICU with AKI requiring CRRT, obesity (BMI>25.0kg/m2) was associated with lower 1-year mortality and 1-year ESRD incidence, suggesting obesity paradox in patient survival and renal survival.