Obesity, acute kidney injury and mortality in patients with sepsis: a cohort analysis.
Although the prognostic effect of obesity has been studied in critically ill patients its impact on outcomes of septic patients and its role as a risk factor for acute kidney injury (AKI) is not consensual. We aimed to analyze the impact of obesity on the occurrence of AKI and on in-hospital mortality in a cohort of critically ill septic patients. This study is retrospective including 456 adult patients with sepsis admitted to the Division of Intensive Medicine of the Centro Hospitalar Lisboa Norte (Lisbon, Portugal) between January 2008 and December 2014. Obesity was defined as a body mass index of 30 kg/m2 or higher. The Kidney Disease Improving Global Outcomes classification was used to diagnose and classify patients developing AKI. AKI occurred in 87.5% of patients (19.5% with stage 1, 22.6% with stage 2 and 45.4% with stage 3). Obese patients developed AKI more frequently than non-obese patients (92.8% versus 85.5%, p = .035; unadjusted OR 2.2 (95% CI: 1.04-4.6), p = .039; adjusted OR 2.31 (95% CI: 1.07-5.02), p = .034). The percentage of obese patients, however, did not differ between AKI stages (stage 1, 25.1%; stage 2, 28.6%; stage 3, 15.4%; p = .145). There was no association between obesity and mortality (p = .739). Of note, when comparing AKI patients with or without obesity in terms of in-hospital mortality there were also no significant differences between those groups (38.4% versus 38.4%, p = .998). Obesity was associated with the occurrence of AKI in critically ill patients with sepsis; however, it was not associated with in-hospital mortality.
['Gameiro|Joana|J|', 'Gonçalves|Miguel|M|http://orcid.org/0000-0001-5351-2411', 'Pereira|Marta|M|', 'Rodrigues|Natacha|N|', 'Godinho|Iolanda|I|', 'Neves|Marta|M|', 'Gouveia|João|J|', 'Silva|Zélia Costa E|ZCE|', 'Jorge|Sofia|S|', 'Lopes|José António|JA|']
D058186:Acute Kidney Injury D000368:Aged D016638:Critical Illness D005260:Female D017052:Hospital Mortality D006801:Humans D007362:Intensive Care Units D008297:Male D008875:Middle Aged D009765:Obesity D011174:Portugal D011379:Prognosis D012189:Retrospective Studies D012307:Risk Factors D018805:Sepsis
Obesity acute kidney injury sepsis epidemiology intensive care survival analysis