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The impact of disease severity on paradoxical association between body mass index and mortality in patients with acute kidney injury undergoing continuous renal replacement therapy

DC Field Value Language
dc.contributor.author강신욱-
dc.contributor.author기연경-
dc.contributor.author김현욱-
dc.contributor.author김형래-
dc.contributor.author남기헌-
dc.contributor.author박서현-
dc.contributor.author박정탁-
dc.contributor.author안성영-
dc.contributor.author유태현-
dc.contributor.author윤해룡-
dc.contributor.author이미솔-
dc.contributor.author정수영-
dc.contributor.author지종현-
dc.contributor.author차민욱-
dc.contributor.author한승혁-
dc.date.accessioned2018-08-28T16:47:19Z-
dc.date.available2018-08-28T16:47:19Z-
dc.date.issued2018-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/161935-
dc.description.abstractBACKGROUND: Association between high body mass index (BMI) and survival benefit is confounded by comorbid conditions such as nutritional status and inflammation. Patients with acute kidney injury (AKI), particularly those receiving continuous renal replacement therapy (CRRT), are highly catabolic and more susceptible to loss of energy. Herein, we evaluated whether disease severity can modify the relationship between BMI and mortality. METHODS: We conducted an observational study in 1144 patients who had undergone CRRT owing to various causes of AKI between 2010 and 2014. Patients were categorized into four groups; underweight (< 18.5 kg/m(2)), normal (18.5-22.99 kg/m(2)), overweight (23.0-24.99 kg/m(2)), and obesity (>/=25 kg/m(2)) according to BMI classification by the Committee of Clinical Practice Guidelines and Korean Society for the Study of Obesity. More severe disease was defined as sepsis-related organ failure assessment (SOFA) score of >/= a median value of 12. The study endpoint was death that occurred within 30 days after the initiation of CRRT. RESULTS: The mean age was 63.2 years and 439 (38.4%) were females. The median BMI was 23.6 (20.9-26.2) kg/m(2). The obese group were younger and higher SOFA score than normal BMI group. In a multivariable Cox regression analysis, we found a significant interaction between BMI and SOFA score (P < 0.001). Furthermore, obese patients were significantly associated with a lower risk of death as compared to normal BMI group after adjusting confounding factors [hazard ratio (HR), 0.81; 95% confidence interval (CI), 0.68-0.97; P = 0.03]. This association was only evident among patients with high severity (HR, 0.61; 95% CI, 0.48-0.76, P < 0.001). In contrast, in those with low severity, survival benefit of high BMI was lost, whereas underweight was associated with an increased risk of death (HR, 1.74; 95% CI, 1.16-2.60; P = 0.007). CONCLUSION: In this study, we found a survival benefit of high BMI in AKI patients undergoing CRRT, particularly in those with more disease severity; the effect was not observed in those with less disease severity.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherBioMed Central-
dc.relation.isPartOfBMC NEPHROLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleThe impact of disease severity on paradoxical association between body mass index and mortality in patients with acute kidney injury undergoing continuous renal replacement therapy-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Internal Medicine-
dc.contributor.googleauthorHyoungnae Kim-
dc.contributor.googleauthorHyunwook Kim-
dc.contributor.googleauthorMisol Lee-
dc.contributor.googleauthorMin-Uk Cha-
dc.contributor.googleauthorKi Heon Nam-
dc.contributor.googleauthorSeong Yeong An-
dc.contributor.googleauthorSu-Young Jung-
dc.contributor.googleauthorJong Hyun Jhee-
dc.contributor.googleauthorSeohyun Park-
dc.contributor.googleauthorHae-Ryong Yun-
dc.contributor.googleauthorYoun Kyung Kee-
dc.contributor.googleauthorHyung Jung Oh-
dc.contributor.googleauthorJung Tak Park-
dc.contributor.googleauthorTae Ik Chang-
dc.contributor.googleauthorTae-Hyun Yoo-
dc.contributor.googleauthorShin-Wook Kang-
dc.contributor.googleauthorSeung Hyeok Han-
dc.identifier.doi10.1186/s12882-018-0833-5-
dc.contributor.localIdA00053-
dc.contributor.localIdA00276-
dc.contributor.localIdA01126-
dc.contributor.localIdA01147-
dc.contributor.localIdA01244-
dc.contributor.localIdA01495-
dc.contributor.localIdA01654-
dc.contributor.localIdA02236-
dc.contributor.localIdA02526-
dc.contributor.localIdA04617-
dc.contributor.localIdA02771-
dc.contributor.localIdA04667-
dc.contributor.localIdA03970-
dc.contributor.localIdA05046-
dc.contributor.localIdA04304-
dc.relation.journalcodeJ00367-
dc.identifier.eissn1471-2369-
dc.identifier.pmid29415663-
dc.subject.keywordAcute kidney injury-
dc.subject.keywordBody mass index-
dc.subject.keywordContinuous renal replacement therapy-
dc.subject.keywordDisease severity-
dc.subject.keywordMortality-
dc.contributor.alternativeNameKang, Shin Wook-
dc.contributor.alternativeNameKee, Youn Kyung-
dc.contributor.alternativeNameKim, Hyun Wook-
dc.contributor.alternativeNameKim, Hyoung Rae-
dc.contributor.alternativeNameNam, Ki Heon-
dc.contributor.alternativeNamePark, Seo Hyun-
dc.contributor.alternativeNamePark, Jung Tak-
dc.contributor.alternativeNameAn, Seong Yeong-
dc.contributor.alternativeNameYoo, Tae Hyun-
dc.contributor.alternativeNameYun, Hae Ryong-
dc.contributor.alternativeNameLee, Mi Sol-
dc.contributor.alternativeNameJung, Su Young-
dc.contributor.alternativeNameJhee, Jong Hyun-
dc.contributor.alternativeNameCha, Min Uk-
dc.contributor.alternativeNameHan, Seung Hyeok-
dc.contributor.affiliatedAuthorKang, Shin Wook-
dc.contributor.affiliatedAuthorKee, Youn Kyung-
dc.contributor.affiliatedAuthorKim, Hyun Wook-
dc.contributor.affiliatedAuthorKim, Hyoung Rae-
dc.contributor.affiliatedAuthorNam, Ki Heon-
dc.contributor.affiliatedAuthorPark, Seo Hyun-
dc.contributor.affiliatedAuthorPark, Jung Tak-
dc.contributor.affiliatedAuthorAn, Seong Yeong-
dc.contributor.affiliatedAuthorYoo, Tae Hyun-
dc.contributor.affiliatedAuthorYun, Hae Ryong-
dc.contributor.affiliatedAuthorLee, Mi Sol-
dc.contributor.affiliatedAuthorJung, Su Young-
dc.contributor.affiliatedAuthorJhee, Jong Hyun-
dc.contributor.affiliatedAuthorCha, Min Uk-
dc.contributor.affiliatedAuthorHan, Seung Hyeok-
dc.citation.volume19-
dc.citation.number1-
dc.citation.startPage32-
dc.identifier.bibliographicCitationBMC NEPHROLOGY, Vol.19(1) : 32, 2018-
dc.identifier.rimsid59525-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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