Résumé
In patients with obesity, data on the outcomes associated with renal replacement therapy are scarce. The main objective of this study was to compare the 90-day mortality between patients who required renal replacement therapy (RRT) and patients who did not require RRT in a population with obesity in the ICU. Material and methods: we conducted a retrospective, single-center study. The data were prospectively collected from June 2009 to May 2022. We included all patients with obesity (defined by body mass index ≥ 30 kg/m2) admitted in a mixed medical-surgical adult ICU in France. Urine output (UO) in the first 24 hours after admission and serum creatinine (SCr) were assessed at admission and daily, hence permitting to stage the severity of acute kidney injury according to the KDIGO classification. The RRT-status was assessed during the entire ICU stay, based on medical records. A Kaplan-Meier analysis and a logistic regression were used for mortality at day 90. Results: a total of 1772 patients with obesity were included. Among them, 253 (14.3%) patients required RRT, and 1519 (85.7%) patients did not; the mortality rate at day 90 was respectively 50.6% (95% CI [44.4 %-56.7 %]) and 19.6% (95% CI [17.6%-21.6%]). The mortality rate at 90 days after ICU admission was significantly higher in the RRT group (p < 0.0001 with log rank test). In a multivariate logistic regression, RRT was independently associated with mortality at day 90 after ICU admission with an odds ratio (OR) of 2.3 (95% CI [1.7-3.2]). Conclusion: in a population of patients with obesity, the occurrence of renal replacement therapy during ICU stay was independently associated with mortality at day 90 after ICU admission. This data suggests a lack of evidence in this specific population, and contribute to put forward the necessity of prospective, well conducted trials.