Obesity and post-cardiopulmonary bypass-associated acute kidney injury: A single-center retrospective analysis

摘要

Objective The authors specifically explored the association of obesity (based on body mass index [BMI]) and the risk of developing acute kidney injury after cardiopulmonary bypass (AKICPB). Design Single-center retrospective study. Setting Academic medical center. Participants and Interventions After IRB approval, 376 eligible adults who underwent cardiac surgery with cardiopulmonary bypass between 2006-2010 were included in the final retrospective analysis. Patients undergoing "off-pump" procedures, cardiac transplants, repair of congenital heart disease, and patients with preoperative circulatory assist devices were excluded. Results The overall incidence of developing AKICPB in this population based on the Acute Kidney Injury Network serum creatinine criteria was 39% (147 of 376). Among the BMI classes, the morbidly obese cohort (ie, BMI40 kg/m2) had a significantly greater risk of developing AKICPB than those in lower BMI classes. BMI40 kg/m2 was significantly associated with development of AKICPB even after accounting for covariates (ie, diabetes mellitus, hypertension, age, severity of illness, and CPB time) (overall p = 0.018). The odds ratio of AKICPB in the BMI40 kg/m2 cohort relative to BMI25 kg/m2 was 2.39 (95% CI: 0.98, 5.82; p = 0.055), with no significant difference in risk of developing AKICPB among the 4 lower BMI classes. Conclusion BMI40 kg/m 2 is associated with a significantly higher risk of developing of AKICPB.