Key result
Underweight BMI was associated with a higher 90-day mortality risk compared to obesity in critically ill patients with severe AKI (HR 1.20; 95% CI 1.05-1.36; p=0.006), an effect driven by males.
Why the study?
Although obesity typically correlates with adverse outcomes, certain acute critical illnesses exhibit an obesity paradox, prompting evaluation of sex-specific prognostic implications of BMI in severe AKI requiring CRRT.
Does BMI category affect 90-day mortality differently in male versus female critically ill patients with severe AKI requiring CRRT?
Cohort (n=3,805)
Yes
Does BMI category affect 90-day mortality differently in male versus female critically ill patients with severe AKI requiring CRRT?
An obesity paradox exists in critically ill male patients with severe AKI requiring CRRT, where obesity is associated with lower 90-day mortality, but this protective effect is not observed in females.
Should not yet alter sex-specific BMI-based risk stratification for CRRT patients; leaves open confirmatory studies and body-composition mechanisms.
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Jung et al. (2024) conducted a cohort in Severe acute kidney injury requiring continuous renal replacement therapy (n=3,805). Underweight BMI vs. Obese BMI was evaluated on 90-day mortality (HR 1.20, 95% CI 1.05-1.36, p=0.006). Underweight BMI was associated with a higher 90-day mortality risk compared to obesity in critically ill patients with severe AKI (HR 1.20; 95% CI 1.05-1.36; p=0.006), an effect driven by males.
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