Patients who are underweight, overweight or obese at increased risk for AKI
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Patients who were obese, overweight or underweight were at an increased risk for AKI, compared with patients who had a normal BMI, according to data published in the Journal of Renal Nutrition.
Further, a lower BMI correlated with an increased risk of mortality.
“While several studies have assessed the connection of BMI with the incidence and outcomes of AKI, no systematic review and meta-analysis has been attempted,” Jiarong Lan, from the School of Basic Medical Sciences at Zhejiang Chinese Medical University, and colleagues wrote. “It is important to understand if having BMI outside the normal range ie, being underweight, overweight or obese is associated with a higher risk of developing AKI and whether BMI impacts the overall patient prognosis.”
In a meta-analysis of 22 studies, researchers examined AKI across all categories of BMI to determine the impact of BMI on rates of mortality and chronic kidney disease. Studies were derived from PubMed, Scopus and Google Scholar electronic academic databases, and were published before June 30, 2021. Researchers included studies that were cohort-based or had retrospective analyses and investigated outcomes based on BMI categories.
Using STATA version 16.0, researchers conducted the meta-analysis. They also performed a subgroup analysis based on medical-only, surgical-only and mixed medical-surgical patients.
Ultimately, patients who were underweight, overweight or obese showed a higher risk for having AKI compared with patients who had a normal BMI. Researchers identified a correlation between lower-than-normal BMI and a higher mortality risk, while being overweight or obese was associated with a decreased risk of mortality.
Analyses revealed patients who were underweight had a 17% lower risk for CKD, and those who were overweight and obese had a higher CKD risk.
“Our study identified underweight subjects as a high-risk group, given the increased risk of AKI and mortality. Consequently, renal protective strategies might be warranted more in those that are underweight, although overweight and obese patients may benefit as well,” Lan and colleagues wrote. “Future studies should consider investing in understanding the pathophysiologic mechanisms that lead to the increased risk of mortality in underweight subjects. Further it might be helpful to test nutritional indices, other than those based on BMI, that are objective and easily administered and which could potentially identify undernourished subjects at the time of hospital admission.”
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