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Acute kidney injury: a strong risk factor for hypoglycaemia in hospitalized patients with type 2 diabetes
AIMS: Acute kidney injury (AKI) is highly prevalent during hospitalization of patients with type 2 diabetes (T2D). We aimed to assess the impact of AKI and its severity and duration on the risk of hypoglycaemia in hospitalized patients with T2D. METHODS: Retrospective cohort analysis of patients wit...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Milan
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10359379/ https://www.ncbi.nlm.nih.gov/pubmed/37173530 http://dx.doi.org/10.1007/s00592-023-02112-0 |
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author | Carreira, Ana Castro, Pedro Mira, Filipe Melo, Miguel Ribeiro, Pedro Santos, Lèlita |
author_facet | Carreira, Ana Castro, Pedro Mira, Filipe Melo, Miguel Ribeiro, Pedro Santos, Lèlita |
author_sort | Carreira, Ana |
collection | PubMed |
description | AIMS: Acute kidney injury (AKI) is highly prevalent during hospitalization of patients with type 2 diabetes (T2D). We aimed to assess the impact of AKI and its severity and duration on the risk of hypoglycaemia in hospitalized patients with T2D. METHODS: Retrospective cohort analysis of patients with T2D, admitted at a University Hospital in 2018–2019. AKI was defined as an increase in serum creatinine by ≥ 0.3 mg/dl (48 h) or ≥ 1.5 times baseline (7 days), and hypoglycaemia as blood glucose concentration < 70 mg/dl. Patients with chronic kidney disease stage ≥ 4 were excluded. We registered 239 hospitalizations with AKI and randomly selected 239 without AKI (control). Multiple logistic regression was used to adjust for confounding factors and ROC curve analysis to determine a cutoff for AKI duration. RESULTS: The risk of hypoglycaemia was higher in the AKI group (crude OR 3.6, 95%CI 1.8–9.6), even after adjusting for covariates (OR 4.2, 95%CI 1.8–9.6). Each day of AKI duration was associated with a 14% increase in the risk of hypoglycaemia (95%CI 1.1–1.2), and a cutoff of 5.5 days of AKI duration was obtained for increased risk of hypoglycaemia and mortality. AKI severity was also associated with mortality, but showed no significant association with hypoglycaemia. Patients with hypoglycaemia had 4.4 times greater risk of mortality (95%CI 2.4–8.2). CONCLUSIONS: AKI increased the risk of hypoglycaemia during hospitalization of patients with T2D, and its duration was the main risk factor. These results highlight the need for specific protocols to avoid hypoglycaemia and its burden in patients with AKI. |
format | Online Article Text |
id | pubmed-10359379 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Milan |
record_format | MEDLINE/PubMed |
spelling | pubmed-103593792023-07-22 Acute kidney injury: a strong risk factor for hypoglycaemia in hospitalized patients with type 2 diabetes Carreira, Ana Castro, Pedro Mira, Filipe Melo, Miguel Ribeiro, Pedro Santos, Lèlita Acta Diabetol Original Article AIMS: Acute kidney injury (AKI) is highly prevalent during hospitalization of patients with type 2 diabetes (T2D). We aimed to assess the impact of AKI and its severity and duration on the risk of hypoglycaemia in hospitalized patients with T2D. METHODS: Retrospective cohort analysis of patients with T2D, admitted at a University Hospital in 2018–2019. AKI was defined as an increase in serum creatinine by ≥ 0.3 mg/dl (48 h) or ≥ 1.5 times baseline (7 days), and hypoglycaemia as blood glucose concentration < 70 mg/dl. Patients with chronic kidney disease stage ≥ 4 were excluded. We registered 239 hospitalizations with AKI and randomly selected 239 without AKI (control). Multiple logistic regression was used to adjust for confounding factors and ROC curve analysis to determine a cutoff for AKI duration. RESULTS: The risk of hypoglycaemia was higher in the AKI group (crude OR 3.6, 95%CI 1.8–9.6), even after adjusting for covariates (OR 4.2, 95%CI 1.8–9.6). Each day of AKI duration was associated with a 14% increase in the risk of hypoglycaemia (95%CI 1.1–1.2), and a cutoff of 5.5 days of AKI duration was obtained for increased risk of hypoglycaemia and mortality. AKI severity was also associated with mortality, but showed no significant association with hypoglycaemia. Patients with hypoglycaemia had 4.4 times greater risk of mortality (95%CI 2.4–8.2). CONCLUSIONS: AKI increased the risk of hypoglycaemia during hospitalization of patients with T2D, and its duration was the main risk factor. These results highlight the need for specific protocols to avoid hypoglycaemia and its burden in patients with AKI. Springer Milan 2023-05-13 2023 /pmc/articles/PMC10359379/ /pubmed/37173530 http://dx.doi.org/10.1007/s00592-023-02112-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Carreira, Ana Castro, Pedro Mira, Filipe Melo, Miguel Ribeiro, Pedro Santos, Lèlita Acute kidney injury: a strong risk factor for hypoglycaemia in hospitalized patients with type 2 diabetes |
title | Acute kidney injury: a strong risk factor for hypoglycaemia in hospitalized patients with type 2 diabetes |
title_full | Acute kidney injury: a strong risk factor for hypoglycaemia in hospitalized patients with type 2 diabetes |
title_fullStr | Acute kidney injury: a strong risk factor for hypoglycaemia in hospitalized patients with type 2 diabetes |
title_full_unstemmed | Acute kidney injury: a strong risk factor for hypoglycaemia in hospitalized patients with type 2 diabetes |
title_short | Acute kidney injury: a strong risk factor for hypoglycaemia in hospitalized patients with type 2 diabetes |
title_sort | acute kidney injury: a strong risk factor for hypoglycaemia in hospitalized patients with type 2 diabetes |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10359379/ https://www.ncbi.nlm.nih.gov/pubmed/37173530 http://dx.doi.org/10.1007/s00592-023-02112-0 |
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