title: The obesity paradox and acute kidney injury: beneficial effects of hyper-inflammation?
abstract: In the general population, obesity is associated with an increased mortality risk, whereas several epidemiological studies demonstrated a protective effect of obesity in critically ill patients. In this context, Sleeman and colleagues investigated the effects of obesity on kidney function in a well-established porcine model of cardiopulmonary bypass. The authors confirm literature data that obesity per se is associated with a chronic hyper-inflammatory status. Nevertheless, obese swine undergoing the surgical procedure presented with attenuated kidney dysfunction and tissue apoptosis. The authors suggest that the chronic inflammation causes pre-conditioning against excessive acute hyper-inflammation. The authors have to be commended for using a long-term, clinically relevant model that, moreover, addresses a variety of putative mechanisms. The study is discussed in the context of the controversial findings that, in contrast to the existing literature on improved survival, most studies available suggest a higher incidence and severity of acute kidney injury in obese patients when compared with lean controls.
authors: Sebastian
authors: S
authors: Hafner
authors: Andreas
authors: A
authors: Hillenbrand
authors: Uwe
authors: U
authors: Knippschild
authors: Peter
authors: P
authors: Radermacher
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000517:prevention & control*; D000818:Animals; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D059305:Diet, High-Fat; D005260:Female; D009765:Obesity / Q000209:etiology*