title: Morbid obesity is an independent risk factor for postoperative renal dysfunction in young adults: a review of the American College of Surgeons National Surgical Quality Improvement Program database.
abstract: BACKGROUND
  Little information exists on the acute effects of elective surgery on renal function. Our aim was to determine if obesity was an independent risk factor for postoperative renal complications (RCs).
  
  
  METHODS
  A total of 119,142 patients aged 18 to 35 years with body mass index (BMI) ≥18 kg/m(2) obtained from American College of Surgeons National Surgical Quality Improvement Project (2005 to 2010) were classified into standard BMI categories. Association between BMI and preoperative estimated glomerular filtration rate (eGFR; calculated using modification of diet in renal disease formula) was analyzed. Postoperative changes in eGFR and RCs were measured. Multivariate regression analysis was performed adjusting for all variables.
  
  
  RESULTS
  Postoperatively, there was a reduction in eGFR among the overweight (-3.4 mL/min/1.73 m(2), P < .001), obese class I (-3.9 mL/min/1.73 m(2), P = .001), and obese class II (-5.3 mL/min/1.73 m(2), P < .001). The odds of any postoperative RC was significantly higher in obese class III patients (odds ratio = 2.01 95% confidence interval 1.07 to 3.76, P = .029).
  
  
  CONCLUSIONS
  Results seen in patients with BMI greater than 40 indicate that BMI can serve as an independent predictor of RCs.
authors.affiliation: Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Howard University Hospital, 2041 Georgia Avenue NW, Tower Suite 4100-B, Washington, DC 20060, USA.
authors.forename: Cedrina L
authors.initials: CL
authors.lastname: Calder
authors.affiliation: Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Howard University Hospital, 2041 Georgia Avenue NW, Tower Suite 4100-B, Washington, DC 20060, USA.
authors.forename: Gezzer
authors.initials: G
authors.lastname: Ortega
authors.affiliation: Department of Surgery, Howard University College of Medicine, Washington, DC, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Vij
authors.affiliation: Department of Surgery, Howard University College of Medicine, Washington, DC, USA.
authors.forename: Karan
authors.initials: K
authors.lastname: Chawla
authors.affiliation: Department of Surgery, Howard University College of Medicine, Washington, DC, USA.
authors.forename: Chioma
authors.initials: C
authors.lastname: Nnamdi-Emetarom
authors.affiliation: Department of Surgery, Howard University College of Medicine, Washington, DC, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Stephanie
authors.affiliation: Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Howard University Hospital, 2041 Georgia Avenue NW, Tower Suite 4100-B, Washington, DC 20060, USA.
authors.forename: Clive O
authors.initials: CO
authors.lastname: Callender
authors.affiliation: Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Howard University Hospital, 2041 Georgia Avenue NW, Tower Suite 4100-B, Washington, DC 20060, USA. Electronic address: tfullum@howard.edu.
authors.forename: Terrence M
authors.initials: TM
authors.lastname: Fullum
mesh_terms: D000293:Adolescent; D000328:Adult; D017558:Elective Surgical Procedures; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology*; D008297:Male; D009767:Obesity, Morbid / Q000150:complications*; D011183:Postoperative Complications / Q000453:epidemiology*; D058996:Quality Improvement; D012307:Risk Factors
keywords: ACS NSQIP; Morbid obesity; Renal complications; Renal failure