Related Experiment Video
Updated: Jul 9, 2025
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Obesity and Acute Kidney Injury in Patients with ST-Elevation Myocardial Infarction
Vojko Kanic1, David Suran1, Gregor Kompara1
1Division of Internal Medicine, Department of Cardiology and Angiology, University Medical Center Maribor, Ljubljanska Ulica 5, 2000 Maribor, Slovenia.
Insights
Obesity does not increase acute kidney injury (AKI) risk in ST-elevation myocardial infarction (STEMI) patients. However, obesity may offer a survival benefit in STEMI patients who develop AKI.
Area of Science:
- Cardiology
- Nephrology
- Obesity Medicine
Background:
- Limited data exists on the relationship between obesity and acute kidney injury (AKI) in ST-elevation myocardial infarction (STEMI) patients.
- This study investigates the association between obesity and AKI, as well as patient outcomes.
Purpose of the Study:
- To evaluate the association between body mass index (BMI) and AKI incidence in STEMI patients.
- To assess the impact of obesity on AKI and mortality in STEMI patients.
Main Methods:
- A retrospective study included 3979 STEMI patients who underwent percutaneous coronary intervention (PCI).
- Patients were categorized by BMI and compared for AKI incidence and mortality at 30 days and long-term follow-up.
Main Results:
- AKI incidence was similar across all BMI categories, with no significant association between BMI and AKI.
- AKI was associated with significantly higher 30-day and long-term mortality.
- Obesity was linked to a lower long-term mortality risk in STEMI patients, particularly those with AKI.
Conclusions:
- AKI incidence in STEMI patients appears independent of BMI.
- Obesity demonstrated a protective effect on long-term mortality in STEMI patients who developed AKI.
Background:
Data on the association between obesity and acute kidney injury (AKI) in patients with ST-elevation myocardial infarction (STEMI) are sparse and inconclusive. We aimed to evaluate the association between obesity and AKI and the outcome in these patients.
Methods:
A retrospective observational study of 3979 STEMI patients undergoing percutaneous coronary intervention (PCI) was performed at a single center. Patients with and without AKI were compared. Patients were also divided into three categories according to BMI, and these were compared. All-cause mortality was determined at 30 days and over a median period of 7.0 years.
Results:
The incidence of AKI was similar in all BMI categories. There was no association between BMI categories and AKI (p = 0.089). The Spearman correlation coefficient between BMI categories and AKI showed no correlation (r = -0.005; p = 0.75). More AKI patients died within 30 days and in the long term [137 (18.5%) and 283 (38.1%) patients in the AKI group died compared to 118 (3.6%) and 767 (23.1%) in the non-AKI group; p < 0.0001]. AKI was harmful in all BMI categories (p < 0.0001) and was associated with more than a 2.5-fold and a 1.5-fold multivariable-adjusted 30-day and long-term mortality risk, respectively (aOR 2.59; 95% CI 1.84-3.64; p < 0.0001, aHR 1.54; 95% CI 1.32-1.80; p < 0.0001). BMI categories were not associated with 30-day mortality (p = 0.26) but were associated with long-term mortality (p < 0.0001). Overweight and obese patients had an approximately 25% lower long-term multivariable-adjusted risk of death than normal-weight patients. In patients with AKI, BMI was only associated with long-term risk (p = 0.022). Obesity had an additional beneficial effect in these patients, and only patients with obesity, but not overweight patients, had a lower multivariable adjusted long-term mortality risk than normal-weight patients (aHR 062; 95% CI 0.446-0.88 p = 0.007).
Conclusions:
In patients who experienced AKI, obesity had an additional positive modifying effect. Our data suggest that the incidence of AKI in STEMI patients is not BMI-dependent.
Related Concept Videos
01:21External Anatomy of the Kidney
The kidneys are located in the retroperitoneal space on either side of the vertebral column, protected posteriorly by the 11th and 12th ribs. The right kidney sits slightly lower than the left owing to the presence of the liver...
01:20Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
01:22Heart Failure Drugs: Diuretics
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...