Body mass index is inversely associated with mortality in patients with acute kidney injury undergoing continuous renal replacement therapy

Hyoungnae Kim, Joohwan Kim, Changhwan Seo, Misol Lee, Min Uk Cha, Su Young Jung, Jong Hyun Jhee, Seohyun Park, Hae Ryong Yun, Youn Kyung Kee, Chang Yun Yoon, Hyung Jung Oh, Jung Tak Park, Tae Ik Chang, TaeHyun Yoo, Shin-Wook Kang, SeungHyeok Han

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Many epidemiologic studies have reported on the controversial concept of the obesity paradox. The presence of acute kidney injury (AKI) can accelerate energy-consuming processes, particularly in patients requiring continuous renal replacement therapy (CRRT). Thus, we aimed to investigate whether obesity can provide a survivabenefit in this highly catabolic condition. Methods: We conducted an observational study in 212 patients who had undergone CRRT owing to various causes of AKI between 2010 and 2014. The study end point was defined as death that occurred within 30 days after the initiation of CRRT. Results: Patients were categorized into three groups according to tertiles of body mass index (BMI). During 30 days after the initiation of CRRT, 39 patients (57.4%) in the highest tertile died, as compared with 58 patients (78.4%) in the lowest tertile (P = 0.02). In a multivariable analysis adjusted for cofounding factors, the highest tertile of BMI was significantly associated with a decreased risk of death (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.37-0.87; P = 0.01). This significant association remained unaltered for 60-day (HR, 0.64; 95% CI, 0.43-0.94; P = 0.03and 90-day mortality (HR, 0.66; 95% CI, 0.44-0.97; P = 0.03). Conclusion: This study showed that a higher BMI confer a survival benefit over a lower BMI in AKI patients undergoing CRRT.

Original languageEnglish
Pages (from-to)39-47
Number of pages9
JournalKidney Research and Clinical Practice
Volume36
Issue number1
DOIs
Publication statusPublished - 2017 Mar 1

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Renal Replacement Therapy
Acute Kidney Injury
Body Mass Index
Mortality
Confidence Intervals
Obesity
Observational Studies
Epidemiologic Studies
Survival

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Urology

Cite this

Kim, Hyoungnae ; Kim, Joohwan ; Seo, Changhwan ; Lee, Misol ; Cha, Min Uk ; Jung, Su Young ; Jhee, Jong Hyun ; Park, Seohyun ; Yun, Hae Ryong ; Kee, Youn Kyung ; Yoon, Chang Yun ; Oh, Hyung Jung ; Park, Jung Tak ; Chang, Tae Ik ; Yoo, TaeHyun ; Kang, Shin-Wook ; Han, SeungHyeok. / Body mass index is inversely associated with mortality in patients with acute kidney injury undergoing continuous renal replacement therapy. In: Kidney Research and Clinical Practice. 2017 ; Vol. 36, No. 1. pp. 39-47.
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abstract = "Background: Many epidemiologic studies have reported on the controversial concept of the obesity paradox. The presence of acute kidney injury (AKI) can accelerate energy-consuming processes, particularly in patients requiring continuous renal replacement therapy (CRRT). Thus, we aimed to investigate whether obesity can provide a survivabenefit in this highly catabolic condition. Methods: We conducted an observational study in 212 patients who had undergone CRRT owing to various causes of AKI between 2010 and 2014. The study end point was defined as death that occurred within 30 days after the initiation of CRRT. Results: Patients were categorized into three groups according to tertiles of body mass index (BMI). During 30 days after the initiation of CRRT, 39 patients (57.4{\%}) in the highest tertile died, as compared with 58 patients (78.4{\%}) in the lowest tertile (P = 0.02). In a multivariable analysis adjusted for cofounding factors, the highest tertile of BMI was significantly associated with a decreased risk of death (hazard ratio [HR], 0.57; 95{\%} confidence interval [CI], 0.37-0.87; P = 0.01). This significant association remained unaltered for 60-day (HR, 0.64; 95{\%} CI, 0.43-0.94; P = 0.03and 90-day mortality (HR, 0.66; 95{\%} CI, 0.44-0.97; P = 0.03). Conclusion: This study showed that a higher BMI confer a survival benefit over a lower BMI in AKI patients undergoing CRRT.",
author = "Hyoungnae Kim and Joohwan Kim and Changhwan Seo and Misol Lee and Cha, {Min Uk} and Jung, {Su Young} and Jhee, {Jong Hyun} and Seohyun Park and Yun, {Hae Ryong} and Kee, {Youn Kyung} and Yoon, {Chang Yun} and Oh, {Hyung Jung} and Park, {Jung Tak} and Chang, {Tae Ik} and TaeHyun Yoo and Shin-Wook Kang and SeungHyeok Han",
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Body mass index is inversely associated with mortality in patients with acute kidney injury undergoing continuous renal replacement therapy. / Kim, Hyoungnae; Kim, Joohwan; Seo, Changhwan; Lee, Misol; Cha, Min Uk; Jung, Su Young; Jhee, Jong Hyun; Park, Seohyun; Yun, Hae Ryong; Kee, Youn Kyung; Yoon, Chang Yun; Oh, Hyung Jung; Park, Jung Tak; Chang, Tae Ik; Yoo, TaeHyun; Kang, Shin-Wook; Han, SeungHyeok.

In: Kidney Research and Clinical Practice, Vol. 36, No. 1, 01.03.2017, p. 39-47.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Body mass index is inversely associated with mortality in patients with acute kidney injury undergoing continuous renal replacement therapy

AU - Kim, Hyoungnae

AU - Kim, Joohwan

AU - Seo, Changhwan

AU - Lee, Misol

AU - Cha, Min Uk

AU - Jung, Su Young

AU - Jhee, Jong Hyun

AU - Park, Seohyun

AU - Yun, Hae Ryong

AU - Kee, Youn Kyung

AU - Yoon, Chang Yun

AU - Oh, Hyung Jung

AU - Park, Jung Tak

AU - Chang, Tae Ik

AU - Yoo, TaeHyun

AU - Kang, Shin-Wook

AU - Han, SeungHyeok

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Background: Many epidemiologic studies have reported on the controversial concept of the obesity paradox. The presence of acute kidney injury (AKI) can accelerate energy-consuming processes, particularly in patients requiring continuous renal replacement therapy (CRRT). Thus, we aimed to investigate whether obesity can provide a survivabenefit in this highly catabolic condition. Methods: We conducted an observational study in 212 patients who had undergone CRRT owing to various causes of AKI between 2010 and 2014. The study end point was defined as death that occurred within 30 days after the initiation of CRRT. Results: Patients were categorized into three groups according to tertiles of body mass index (BMI). During 30 days after the initiation of CRRT, 39 patients (57.4%) in the highest tertile died, as compared with 58 patients (78.4%) in the lowest tertile (P = 0.02). In a multivariable analysis adjusted for cofounding factors, the highest tertile of BMI was significantly associated with a decreased risk of death (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.37-0.87; P = 0.01). This significant association remained unaltered for 60-day (HR, 0.64; 95% CI, 0.43-0.94; P = 0.03and 90-day mortality (HR, 0.66; 95% CI, 0.44-0.97; P = 0.03). Conclusion: This study showed that a higher BMI confer a survival benefit over a lower BMI in AKI patients undergoing CRRT.

AB - Background: Many epidemiologic studies have reported on the controversial concept of the obesity paradox. The presence of acute kidney injury (AKI) can accelerate energy-consuming processes, particularly in patients requiring continuous renal replacement therapy (CRRT). Thus, we aimed to investigate whether obesity can provide a survivabenefit in this highly catabolic condition. Methods: We conducted an observational study in 212 patients who had undergone CRRT owing to various causes of AKI between 2010 and 2014. The study end point was defined as death that occurred within 30 days after the initiation of CRRT. Results: Patients were categorized into three groups according to tertiles of body mass index (BMI). During 30 days after the initiation of CRRT, 39 patients (57.4%) in the highest tertile died, as compared with 58 patients (78.4%) in the lowest tertile (P = 0.02). In a multivariable analysis adjusted for cofounding factors, the highest tertile of BMI was significantly associated with a decreased risk of death (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.37-0.87; P = 0.01). This significant association remained unaltered for 60-day (HR, 0.64; 95% CI, 0.43-0.94; P = 0.03and 90-day mortality (HR, 0.66; 95% CI, 0.44-0.97; P = 0.03). Conclusion: This study showed that a higher BMI confer a survival benefit over a lower BMI in AKI patients undergoing CRRT.

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