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Lower Blood Glucose and Variability Are Associated with Earlier Recovery from Renal Injury Caused by Episodic Urinary Tract Infection in Advanced Type 2 Diabetic Chronic Kidney Disease

PURPOSE: In our previous study, type 2 diabetic chronic kidney disease (CKD) patients with glomerular filtration rates of <30 mL/min upon hospitalization for urinary tract infection (UTI) were at a risk for acute kidney injury. This study aimed to clarify the effect of glucose and its variability...

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Autores principales: Chiu, Ping-Fang, Wu, Chia-Lin, Huang, Ching-Hui, Liou, Hung-Hsiang, Chang, Chirn-Bin, Chang, Horng-Rong, Chang, Chia-Chu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4178173/
https://www.ncbi.nlm.nih.gov/pubmed/25259806
http://dx.doi.org/10.1371/journal.pone.0108531
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author Chiu, Ping-Fang
Wu, Chia-Lin
Huang, Ching-Hui
Liou, Hung-Hsiang
Chang, Chirn-Bin
Chang, Horng-Rong
Chang, Chia-Chu
author_facet Chiu, Ping-Fang
Wu, Chia-Lin
Huang, Ching-Hui
Liou, Hung-Hsiang
Chang, Chirn-Bin
Chang, Horng-Rong
Chang, Chia-Chu
author_sort Chiu, Ping-Fang
collection PubMed
description PURPOSE: In our previous study, type 2 diabetic chronic kidney disease (CKD) patients with glomerular filtration rates of <30 mL/min upon hospitalization for urinary tract infection (UTI) were at a risk for acute kidney injury. This study aimed to clarify the effect of glucose and its variability on renal outcomes during admission for the treatment of UTI. MATERIALS AND METHODS: Based on the date of renal recovery (RIFLE criteria: acute kidney injury occurred within 1–7 days and was sustained over 1 day), we divided these patients into early- (≤9 days, Group A) and late-recovery (>9 days, Group B) groups. The differences in the continuous and categorical variables of the two groups were assessed separately. The mean glucose levels and their variability (using the standard deviation and the coefficient of standard deviation) were compared at the fasting, midday pre-meal, evening pre-meal, and evening post-meal time points during hospitalization. We have organized the manuscript in a manner compliant with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. RESULTS: Acute kidney injury occurred within the two groups (p = 0.007 and p = 0.001, respectively). The early-morning blood glucose levels (149.7±44.0 mg/dL) and average blood glucose levels (185.6±52.0 mg/dL) were better in Group A (p = 0.01, p = 0.02). Group A patients also had lower glucose variability than Group B at the different time points (p<0.05). Group A also had earlier renal recovery. More relevant pathogens were identified from blood in Group B (p = 0.038). CONCLUSIONS: Early-morning fasting and mean blood glucose levels and their variability can be good indicators of severe infection and predictors of renal outcome in type 2 diabetic patients with CKD and UTI.
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spelling pubmed-41781732014-10-02 Lower Blood Glucose and Variability Are Associated with Earlier Recovery from Renal Injury Caused by Episodic Urinary Tract Infection in Advanced Type 2 Diabetic Chronic Kidney Disease Chiu, Ping-Fang Wu, Chia-Lin Huang, Ching-Hui Liou, Hung-Hsiang Chang, Chirn-Bin Chang, Horng-Rong Chang, Chia-Chu PLoS One Research Article PURPOSE: In our previous study, type 2 diabetic chronic kidney disease (CKD) patients with glomerular filtration rates of <30 mL/min upon hospitalization for urinary tract infection (UTI) were at a risk for acute kidney injury. This study aimed to clarify the effect of glucose and its variability on renal outcomes during admission for the treatment of UTI. MATERIALS AND METHODS: Based on the date of renal recovery (RIFLE criteria: acute kidney injury occurred within 1–7 days and was sustained over 1 day), we divided these patients into early- (≤9 days, Group A) and late-recovery (>9 days, Group B) groups. The differences in the continuous and categorical variables of the two groups were assessed separately. The mean glucose levels and their variability (using the standard deviation and the coefficient of standard deviation) were compared at the fasting, midday pre-meal, evening pre-meal, and evening post-meal time points during hospitalization. We have organized the manuscript in a manner compliant with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. RESULTS: Acute kidney injury occurred within the two groups (p = 0.007 and p = 0.001, respectively). The early-morning blood glucose levels (149.7±44.0 mg/dL) and average blood glucose levels (185.6±52.0 mg/dL) were better in Group A (p = 0.01, p = 0.02). Group A patients also had lower glucose variability than Group B at the different time points (p<0.05). Group A also had earlier renal recovery. More relevant pathogens were identified from blood in Group B (p = 0.038). CONCLUSIONS: Early-morning fasting and mean blood glucose levels and their variability can be good indicators of severe infection and predictors of renal outcome in type 2 diabetic patients with CKD and UTI. Public Library of Science 2014-09-26 /pmc/articles/PMC4178173/ /pubmed/25259806 http://dx.doi.org/10.1371/journal.pone.0108531 Text en © 2014 Chiu et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Chiu, Ping-Fang
Wu, Chia-Lin
Huang, Ching-Hui
Liou, Hung-Hsiang
Chang, Chirn-Bin
Chang, Horng-Rong
Chang, Chia-Chu
Lower Blood Glucose and Variability Are Associated with Earlier Recovery from Renal Injury Caused by Episodic Urinary Tract Infection in Advanced Type 2 Diabetic Chronic Kidney Disease
title Lower Blood Glucose and Variability Are Associated with Earlier Recovery from Renal Injury Caused by Episodic Urinary Tract Infection in Advanced Type 2 Diabetic Chronic Kidney Disease
title_full Lower Blood Glucose and Variability Are Associated with Earlier Recovery from Renal Injury Caused by Episodic Urinary Tract Infection in Advanced Type 2 Diabetic Chronic Kidney Disease
title_fullStr Lower Blood Glucose and Variability Are Associated with Earlier Recovery from Renal Injury Caused by Episodic Urinary Tract Infection in Advanced Type 2 Diabetic Chronic Kidney Disease
title_full_unstemmed Lower Blood Glucose and Variability Are Associated with Earlier Recovery from Renal Injury Caused by Episodic Urinary Tract Infection in Advanced Type 2 Diabetic Chronic Kidney Disease
title_short Lower Blood Glucose and Variability Are Associated with Earlier Recovery from Renal Injury Caused by Episodic Urinary Tract Infection in Advanced Type 2 Diabetic Chronic Kidney Disease
title_sort lower blood glucose and variability are associated with earlier recovery from renal injury caused by episodic urinary tract infection in advanced type 2 diabetic chronic kidney disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4178173/
https://www.ncbi.nlm.nih.gov/pubmed/25259806
http://dx.doi.org/10.1371/journal.pone.0108531
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