Cargando…

Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus

Purpose: To evaluate the role of diabetes mellitus in the incidence, risk factors, and outcomes of AKI (acute kidney injury) in patients admitted with ACS (acute coronary syndrome). Methods: We performed a comparative evaluation of ACS patients with vs. without DM who developed AKI enrolled in the b...

Descripción completa

Detalles Bibliográficos
Autores principales: Shiyovich, Arthur, Skalsky, Keren, Steinmetz, Tali, Ovdat, Tal, Eisen, Alon, Samara, Abed, Beigel, Roy, Gleitman, Sagi, Kornowski, Ran, Orvin, Katia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584470/
https://www.ncbi.nlm.nih.gov/pubmed/34768451
http://dx.doi.org/10.3390/jcm10214931
_version_ 1784597456863887360
author Shiyovich, Arthur
Skalsky, Keren
Steinmetz, Tali
Ovdat, Tal
Eisen, Alon
Samara, Abed
Beigel, Roy
Gleitman, Sagi
Kornowski, Ran
Orvin, Katia
author_facet Shiyovich, Arthur
Skalsky, Keren
Steinmetz, Tali
Ovdat, Tal
Eisen, Alon
Samara, Abed
Beigel, Roy
Gleitman, Sagi
Kornowski, Ran
Orvin, Katia
author_sort Shiyovich, Arthur
collection PubMed
description Purpose: To evaluate the role of diabetes mellitus in the incidence, risk factors, and outcomes of AKI (acute kidney injury) in patients admitted with ACS (acute coronary syndrome). Methods: We performed a comparative evaluation of ACS patients with vs. without DM who developed AKI enrolled in the biennial ACS Israeli Surveys (ACSIS) between 2000 and 2018. AKI was defined as an absolute increase in serum creatinine (≥0.5 mg/dL) or above 1.5 mg/dL or new renal replacement therapy upon admission with ACS. Outcomes included 30-day major adverse cardiovascular events (MACE) and 1-year all-cause mortality. Results: The current study included a total of 16,879 patients, median age 64 (IQR 54–74), 77% males, 36% with DM. The incidence of AKI was significantly higher among patients with vs. without DM (8.4% vs. 4.7%, p < 0.001). The rates of 30-day MACE (40.8% vs. 13.4%, p < 0.001) and 1-year mortality (43.7% vs. 10%, p < 0.001) were significantly greater among diabetic patients who developed vs. those who did not develop AKI respectively, yet very similar among patients that developed AKI with vs. without DM (30-day MACE 40.8% vs. 40.3%, p = 0.9 1-year mortality 43.7 vs. 44.8%, p = 0.8, respectively). Multivariate analyses adjusted to potential confounders, showed similar independent predictors of AKI among patients with and without DM, comprising; older age, chronic kidney disease, congestive heart failure, and peripheral arterial disease. Conclusions: Although patients with DM are at much greater risk for AKI when admitted with ACS, the independent predictors of AKI and the worse patient outcomes when AKI occurs, are similar irrespective to DM status.
format Online
Article
Text
id pubmed-8584470
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-85844702021-11-12 Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus Shiyovich, Arthur Skalsky, Keren Steinmetz, Tali Ovdat, Tal Eisen, Alon Samara, Abed Beigel, Roy Gleitman, Sagi Kornowski, Ran Orvin, Katia J Clin Med Article Purpose: To evaluate the role of diabetes mellitus in the incidence, risk factors, and outcomes of AKI (acute kidney injury) in patients admitted with ACS (acute coronary syndrome). Methods: We performed a comparative evaluation of ACS patients with vs. without DM who developed AKI enrolled in the biennial ACS Israeli Surveys (ACSIS) between 2000 and 2018. AKI was defined as an absolute increase in serum creatinine (≥0.5 mg/dL) or above 1.5 mg/dL or new renal replacement therapy upon admission with ACS. Outcomes included 30-day major adverse cardiovascular events (MACE) and 1-year all-cause mortality. Results: The current study included a total of 16,879 patients, median age 64 (IQR 54–74), 77% males, 36% with DM. The incidence of AKI was significantly higher among patients with vs. without DM (8.4% vs. 4.7%, p < 0.001). The rates of 30-day MACE (40.8% vs. 13.4%, p < 0.001) and 1-year mortality (43.7% vs. 10%, p < 0.001) were significantly greater among diabetic patients who developed vs. those who did not develop AKI respectively, yet very similar among patients that developed AKI with vs. without DM (30-day MACE 40.8% vs. 40.3%, p = 0.9 1-year mortality 43.7 vs. 44.8%, p = 0.8, respectively). Multivariate analyses adjusted to potential confounders, showed similar independent predictors of AKI among patients with and without DM, comprising; older age, chronic kidney disease, congestive heart failure, and peripheral arterial disease. Conclusions: Although patients with DM are at much greater risk for AKI when admitted with ACS, the independent predictors of AKI and the worse patient outcomes when AKI occurs, are similar irrespective to DM status. MDPI 2021-10-25 /pmc/articles/PMC8584470/ /pubmed/34768451 http://dx.doi.org/10.3390/jcm10214931 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Shiyovich, Arthur
Skalsky, Keren
Steinmetz, Tali
Ovdat, Tal
Eisen, Alon
Samara, Abed
Beigel, Roy
Gleitman, Sagi
Kornowski, Ran
Orvin, Katia
Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus
title Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus
title_full Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus
title_fullStr Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus
title_full_unstemmed Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus
title_short Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus
title_sort acute kidney injury following admission with acute coronary syndrome: the role of diabetes mellitus
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584470/
https://www.ncbi.nlm.nih.gov/pubmed/34768451
http://dx.doi.org/10.3390/jcm10214931
work_keys_str_mv AT shiyovicharthur acutekidneyinjuryfollowingadmissionwithacutecoronarysyndrometheroleofdiabetesmellitus
AT skalskykeren acutekidneyinjuryfollowingadmissionwithacutecoronarysyndrometheroleofdiabetesmellitus
AT steinmetztali acutekidneyinjuryfollowingadmissionwithacutecoronarysyndrometheroleofdiabetesmellitus
AT ovdattal acutekidneyinjuryfollowingadmissionwithacutecoronarysyndrometheroleofdiabetesmellitus
AT eisenalon acutekidneyinjuryfollowingadmissionwithacutecoronarysyndrometheroleofdiabetesmellitus
AT samaraabed acutekidneyinjuryfollowingadmissionwithacutecoronarysyndrometheroleofdiabetesmellitus
AT beigelroy acutekidneyinjuryfollowingadmissionwithacutecoronarysyndrometheroleofdiabetesmellitus
AT gleitmansagi acutekidneyinjuryfollowingadmissionwithacutecoronarysyndrometheroleofdiabetesmellitus
AT kornowskiran acutekidneyinjuryfollowingadmissionwithacutecoronarysyndrometheroleofdiabetesmellitus
AT orvinkatia acutekidneyinjuryfollowingadmissionwithacutecoronarysyndrometheroleofdiabetesmellitus