TY - JOUR
T1 - Body mass index and chronic kidney disease outcomes after acute kidney injury
T2 - a prospective matched cohort study
AU - for the ASSESS-AKI Study Investigators
AU - MacLaughlin, Helen L.
AU - Pike, Mindy
AU - Selby, Nicholas M.
AU - Siew, Edward
AU - Chinchilli, Vernon M.
AU - Guide, Andrew
AU - Stewart, Thomas G.
AU - Himmelfarb, Jonathan
AU - Go, Alan S.
AU - Parikh, Chirag R.
AU - Ghahramani, Nasrollah
AU - Kaufman, James
AU - Ikizler, T. Alp
AU - Robinson-Cohen, Cassianne
AU - Kaufman, James S.
AU - Kimmel, Paul L.
AU - Stokes, John B.
AU - Coca, Steven
AU - Garg, Amit
AU - Hsu, Chi yuan
AU - Hsu, Raymond K.
AU - Liu, Kathleen D.
AU - Reeves, W. Brian
AU - Lewis, Julia B.
AU - Ware, Lorraine
AU - Devarajan, Prasad
AU - Krawczeski, Catherine
AU - Bennett, Michael
AU - Zappitelli, Michael
AU - Wurfel, Mark
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Background: Acute kidney injury (AKI) and obesity are independent risk factors for chronic kidney disease (CKD). This study aimed to determine if obesity modifies risk for CKD outcomes after AKI. Methods: This prospective multisite cohort study followed adult survivors after hospitalization, with or without AKI. The primary outcome was a combined CKD event of incident CKD, progression of CKD and kidney failure, examined using time-to-event Cox proportional hazards models, adjusted for diabetes status, age, pre-existing CKD, cardiovascular disease status and intensive care unit admission, and stratified by study center. Body mass index (BMI) was added as an interaction term to examine effect modification by body size. Results: The cohort included 769 participants with AKI and 769 matched controls. After median follow-up of 4.3 years, among AKI survivors, the rate of the combined CKD outcome was 84.7 per1000-person-years with BMI ≥30 kg/m2, 56.4 per 1000-person-years with BMI 25–29.9 kg/m2, and 72.6 per 1000-person-years with BMI 20–24.9 kg/m2. AKI was associated with a higher risk of combined CKD outcomes; adjusted-HR 2.43 (95%CI 1.87–3.16), with no evidence that this was modified by BMI (p for interaction = 0.3). After adjustment for competing risk of death, AKI remained associated with a higher risk of the combined CKD outcome (subdistribution-HR 2.27, 95%CI 1.76–2.92) and similarly, there was no detectable effect of BMI modifying this risk. Conclusions: In this post-hospitalization cohort, we found no evidence for obesity modifying the association between AKI and development or progression of CKD.
AB - Background: Acute kidney injury (AKI) and obesity are independent risk factors for chronic kidney disease (CKD). This study aimed to determine if obesity modifies risk for CKD outcomes after AKI. Methods: This prospective multisite cohort study followed adult survivors after hospitalization, with or without AKI. The primary outcome was a combined CKD event of incident CKD, progression of CKD and kidney failure, examined using time-to-event Cox proportional hazards models, adjusted for diabetes status, age, pre-existing CKD, cardiovascular disease status and intensive care unit admission, and stratified by study center. Body mass index (BMI) was added as an interaction term to examine effect modification by body size. Results: The cohort included 769 participants with AKI and 769 matched controls. After median follow-up of 4.3 years, among AKI survivors, the rate of the combined CKD outcome was 84.7 per1000-person-years with BMI ≥30 kg/m2, 56.4 per 1000-person-years with BMI 25–29.9 kg/m2, and 72.6 per 1000-person-years with BMI 20–24.9 kg/m2. AKI was associated with a higher risk of combined CKD outcomes; adjusted-HR 2.43 (95%CI 1.87–3.16), with no evidence that this was modified by BMI (p for interaction = 0.3). After adjustment for competing risk of death, AKI remained associated with a higher risk of the combined CKD outcome (subdistribution-HR 2.27, 95%CI 1.76–2.92) and similarly, there was no detectable effect of BMI modifying this risk. Conclusions: In this post-hospitalization cohort, we found no evidence for obesity modifying the association between AKI and development or progression of CKD.
KW - Body mass index (BMI)
KW - Kidney
KW - Mortality
KW - Obesity
UR - http://www.scopus.com/inward/record.url?scp=85106970448&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85106970448&partnerID=8YFLogxK
U2 - 10.1186/s12882-021-02400-3
DO - 10.1186/s12882-021-02400-3
M3 - Article
C2 - 34049502
AN - SCOPUS:85106970448
SN - 1471-2369
VL - 22
JO - BMC Nephrology
JF - BMC Nephrology
IS - 1
M1 - 200
ER -