ReviewKidney diseases (Basel, Switzerland)2020
Obesity and the Survival of Critically Ill Patients with Acute Kidney Injury: A Paradox within the Paradox?
Review in Kidney diseases (Basel, Switzerland), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Protein-Energy Wasting Assessment and Clinical Outcomes in Patients with Acute Kidney Injury: A Systematic Review with Meta-Analysis.Nutrients · 2020Pooled it
- Prospective model for predicting renal recovery in cardiac surgery patients with acute kidney injury requiring renal replacement therapy.Nephrology (Carlton, Vic.) · 2021Trial
- Early Detection of Clinical Deterioration in ICU Patients With Respiratory Failure Receiving Vasoactive Support: A Machine Learning Approach to Identifying High-Risk Individuals.Health science reports · 2026Article
- Article
- Association between triglyceride glucose-body mass index and all-cause mortality in patients with sepsis: Evidence from a retrospective cohort study.The Journal of international medical research · 2026Observational
- Obesity exacerbates ischemia-reperfusion injury and senescence in murine kidneys and perirenal adipose tissues.Kidney research and clinical practice · 2025Article
- Electrolyte Imbalances and Metabolic Emergencies in Obesity: Mechanisms and Clinical Implications.Diseases (Basel, Switzerland) · 2025Review
- Obesity aggravates acute kidney injury resulting from ischemia and reperfusion in mice.Scientific reports · 2024Article
- Impact of acute kidney injury and renal recovery status in deceased donor to kidney transplant outcome: results from the Thai national transplant registry.Scientific reports · 2023Article
- Construction and validation of a risk assessment model for acute kidney injury in patients with acute pancreatitis in the intensive care unit.BMC nephrology · 2023Article
- BMI Modifies Increased Mortality Risk of Post-PCI STEMI Patients with AKI.Journal of clinical medicine · 2022Article
- Machine learning to predict in-hospital mortality among patients with severe obesity: Proof of concept study.Obesity science & practice · 2022Article
- Risk factors and outcome variables of cardiorenal syndrome type 1 from the nephrologist's perspective.International urology and nephrology · 2022Article
- The effect of body mass index on the development of acute kidney injury and mortality in intensive care unit: is obesity paradox valid?Renal failure · 2021Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The obesity epidemic is reflected by the rising number of obese patients requiring intensive care. Obesity is a recognized risk factor for the development of acute kidney injury (AKI) in critically ill patients. Both acute critical illness and AKI are associated with higher in-hospital mortality rates, and intensive care unit (ICU) patients suffering from AKI have an elevated risk of death. The relationships between obesity and mortality in critically ill paediatric and adult patients with or without AKI are less clear. Conflicting evidence exists regarding the potential impact of body mass index on the mortality of ICU patients with AKI. Some studies looking at the ICU outcomes of critically ill obese patients with AKI show reduced mortality and others show either no association or elevated mortality. Despite a high biologic plausibility of the proposed causal mechanisms, such as a greater haemodynamic stability and the protective cytokine, adipokine, and lipoprotein defence profiles associated with obesity, the inconsistency of the data suggests that the obesity paradox is a statistical fallacy and the result of chance, bias, and residual confounding variables in retrospective cohort analyses. Further prospective randomized trials are essential to elucidate the role of obesity and the mechanisms underlying a potential survival benefit of obesity in critically ill patients with AKI.
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Registered trials
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