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Updated: Jun 28, 2025
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Obesity is associated with acute kidney injury in ST-segment-elevation myocardial infarction undergoing percutaneous
Congyan Ye1, Xueping Ma1,2,3, Bo Shi1
1Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China.
Insights
Obesity increases the risk of acute kidney injury (AKI) in patients undergoing percutaneous coronary intervention (PCI) for ST-segment-elevation myocardial infarction (STEMI). This association is particularly strong in female patients.
Area of Science:
- Cardiology
- Nephrology
- Public Health
Background:
- Acute kidney injury (AKI) is a serious complication following percutaneous coronary intervention (PCI) for ST-segment-elevation myocardial infarction (STEMI).
- The impact of obesity on AKI risk in STEMI patients undergoing PCI has not been previously investigated.
Purpose of the Study:
- To examine the association between obesity and the incidence of AKI in patients with STEMI undergoing PCI.
- To determine if obesity is an independent risk factor for AKI in this patient population.
Main Methods:
- Utilized the National Inpatient Sample (2016-2019) database.
- Identified adult patients with STEMI undergoing PCI, categorizing them into obese and nonobese cohorts.
- Employed multivariate regression and subgroup analyses to assess the impact of obesity on AKI incidence.
Main Results:
- A total of 529,016 patients were analyzed, with 9.80% experiencing AKI.
- Obesity was positively associated with a higher risk of AKI (aOR: 1.24, 95% CI: 1.15-1.34).
- The association was more pronounced in female patients (aOR: 1.56, 95% CI: 1.33-1.82), and AKI incidence increased over the study period, consistently higher in obese individuals.
Conclusions:
- Obesity is an independent risk factor for AKI in STEMI patients undergoing PCI.
- Female patients with obesity face a significantly greater risk of AKI in this context.
- Findings highlight the importance of considering obesity in AKI risk assessment and prevention strategies for STEMI patients.
Background:
Acute kidney injury (AKI) is a frequent and potentially life-threatening complication after percutaneous coronary intervention (PCI) in patients with ST-segment-elevation myocardial infarction (STEMI). However, the relationship between obesity and the risk of AKI in this specific patient population has not been previously examined.
Methods:
We queried the National Inpatient Sample (2016-2019) using ICD-10 codes to obtain a sample of adults with STEMI undergoing PCI. All patients were further subcategorized into obese and nonobese cohorts. The primary outcome was the incidence of AKI. Multivariate regression analysis was performed to assess the impact of obesity on AKI. The consistency of this correlation between subgroups was investigated using subgroup analysis and interaction testing.
Results:
A total of 62,599 (weighted national estimate of 529,016) patients were identified, of which 9.80% (n = 6137) had AKI. Obesity comprised 19.78% (n = 1214) of the AKI cohort. Obese patients were on average younger, male, white, and had more comorbidities. Additionally, there was a significant positive association between obesity and AKI incidence (adjusted odds ratio [aOR]: 1.24, 95% confidence interval [CI]: 1.15-1.34), which was more pronounced in female patients (aOR: 1.56, 95% CI: 1.33-1.82, p < 0.001, p-interaction = 0.008). The AKI incidence in these patients increased steadily during the 4-year study period, and it was consistently higher in obese patients than in nonobese patients (p-trend < 0.001 for all).
Conclusions:
Obesity was independently associated with a greater risk of AKI among adults with STEMI undergoing PCI, particularly in female patients.
