AUTHOR=Shi Ning , Liu Kang , Fan Yuanming , Yang Lulu , Zhang Song , Li Xu , Wu Hanzhang , Li Meiyuan , Mao Huijuan , Xu Xueqiang , Ma Shi-Ping , Xiao Pingxi , Jiang Shujun TITLE=The Association Between Obesity and Risk of Acute Kidney Injury After Cardiac Surgery JOURNAL=Frontiers in Endocrinology VOLUME=11 YEAR=2020 URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2020.534294 DOI=10.3389/fendo.2020.534294 ISSN=1664-2392 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.