Key result
Post-CABG obesity is linked to higher AKI risk and underweight status to higher mortality.
Why the study?
The relationship of obesity with acute kidney injury and long-term mortality remained undetermined in patients undergoing coronary artery bypass grafting.
Does body mass index category affect the risk of acute kidney injury and long-term mortality in patients undergoing coronary artery bypass grafting?
Cohort (n=3,018)
Yes
Does body mass index category affect the risk of acute kidney injury and long-term mortality in patients undergoing coronary artery bypass grafting?
In patients undergoing coronary artery bypass grafting, obesity increases the risk of post-surgical acute kidney injury, while being underweight is associated with higher long-term mortality, demonstrating an obesity paradox for survival.
Should not yet change CABG practice by BMI; leaves open prospective validation of obesity paradox for AKI and mortality.
BACKGROUND: Obesity is related to several comorbidities and mortality, but its relationship with acute kidney injury (AKI) and long-term mortality remain undetermined in patients undergoing coronary artery bypass grafting. METHODS: Data from 3,018 patients (age ≥ 18 years) who underwent coronary artery bypass graft surgery from two tertiary referral centers were retrospectively reviewed between 2004 and 2015. Obesity was defined using the body mass index, according to the World Health Organization's recommendation. The odds and hazard ratios in post-surgical, AKI, and all-cause mortality were calculated after adjustment for multiple covariates. Patients were followed for 90 ± 40.9 months (maximum: 13 years). RESULTS: Among the cohort, 37.4%, 2.4%, 21.1%, 35.1%, and 4.0% of patients were classified as normal weight, underweight, overweight-at-risk, obese I, and obese II, respectively. Post-surgical AKI developed in 799 patients (26.5%). Patients in the obese groups (overweight-at-risk to obese II) had a higher risk of AKI than did those in the normal-weight group. During the follow-up period, 787 patients (26.1%) died. Underweight patients had a higher risk of mortality than did normal-weight patients, whereas overweight-at-risk, obese I, and obese II patients showed better survival rates. CONCLUSION: After coronary artery bypass graft surgery, obese patients encountered a high risk of AKI, and underweight patients exhibited a low chance of survival. Awareness of both obese and underweight statuses should be raised in these patients.
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Moon et al. (2018) conducted a cohort in Coronary artery bypass grafting (n=3,018). Obesity (Body mass index categories) vs. Normal weight was evaluated on Post-surgical acute kidney injury (AKI) and all-cause mortality. After coronary artery bypass grafting, obese patients had a higher risk of acute kidney injury (overall rate 26.5%), whereas underweight patients had a higher risk of mortality (overall rate 26.1%).
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