Acute kidney injury (AKI) is a common postoperative complication of orthotopic liver transplantation (OLT). So far, little attention has been paid on the association between overweight and AKI after OLT, and animal models or clinical studies have drawn conflicting conclusions. The objective of our study was to determine whether overweight (BMI [Body Mass Index] ≥ 25 kg/m2) is associated with an increased risk of AKI after OLT. This retrospective cohort study included 244 patients receiving OLT in the Affiliated Hospital of Qingdao University between January 1, 2017, and August 29, 2019. Preoperative, intraoperative, and postoperative data were collected retrospectively. The primary outcome was the development of AKI as defined by Kidney Disease, Improving Global Outcome (KIDGO) staging system. Logistic regression analysis was used to determine the relationship between overweight and the occurrence of postoperative AKI. Data analysis was conducted from September to October 2019, revision in April 2020. Among 244 patients receiving OLT (mean [standard deviation] age, 54.1 [9.6] years; 84.0% male) identified, 163 patients (66.8%) developed postoperative AKI. Overweight (BMI ≥ 25 kg/m2) was associated with a higher rate of postoperative severe AKI (stage 2/3) compared with normal weight (18.5 ≤ BMI < 25 kg/m2) (41 [47.7%] vs 39 [28.7%]; adjusted odds ratio [OR], 2.539; 95% confidence interval [CI], 1.389–4.642; P = 0.002). Furthermore, patients with obese were at even higher risk of postoperative severe AKI after controlling for confounding factors (adjusted OR: 3.705; 95% CI: 1.108–12.388; P = 0.033). Overweight is independently associated with an increased risk of postoperative severe AKI among patients receiving OLT. The association of BMI with severe AKI after OLT is J-shaped.

中文翻译：

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接受原位肝移植的患者超重与术后急性肾损伤的关联：一项观察性队列研究。


急性肾损伤（AKI）是原位肝移植（OLT）术后常见的并发症。迄今为止，人们很少关注超重与 OLT 后 AKI 之间的关联，动物模型或临床研究得出了相互矛盾的结论。我们研究的目的是确定超重（BMI [体重指数] ≥ 25 kg/m2）是否与 OLT 后 AKI 风险增加相关。本回顾性队列研究纳入2017年1月1日至2019年8月29日在青岛大学附属医院接受OLT治疗的244例患者，回顾性收集术前、术中和术后数据。主要结局是根据肾脏疾病改善全球结局 (KIDGO) 分期系统定义的 AKI 的发展。采用Logistic回归分析确定超重与术后AKI发生的关系。数据分析于 2019 年 9 月至 10 月进行，并于 2020 年 4 月进行修订。在 244 名接受 OLT 的患者（平均[标准差]年龄，54.1[9.6]岁；84.0% 男性）中发现，163 名患者（66.8%）出现术后 AKI。与正常体重（18.5 ≤ BMI < 25 kg/m2）相比，超重（BMI ≥ 25 kg/m2）与术后严重 AKI（2/3 期）发生率较高相关（41 [47.7%] vs 39 [28.7%] ]；调整后的比值比 [OR]，2.539；95% 置信区间 [CI]，1.389–4.642；P = 0.002）。此外，在控制混杂因素后，肥胖患者发生术后严重 AKI 的风险甚至更高（调整后 OR：3.705；95% CI：1.108–12.388；P = 0.033）。接受 OLT 的患者中，超重与术后严重 AKI 风险增加独立相关。 BMI 与 OLT 后严重 AKI 的关系呈 J 形。