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Association Between Iron Metabolism and Acute Kidney Injury in Critically Ill Patients With Diabetes
OBJECTIVE: Iron overload plays an important role in the pathogenesis of diabetes and acute kidney injury (AKI). The aim of this present study was to explore the relationship between iron metabolism and AKI in patients with diabetes. METHODS: The clinical data of diabetes patients from MIMIC-III data...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9098924/ https://www.ncbi.nlm.nih.gov/pubmed/35574018 http://dx.doi.org/10.3389/fendo.2022.892811 |
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author | Mo, Manqiu Gao, Yunqing Deng, Ling Liang, Yuzhen Xia, Ning Pan, Ling |
author_facet | Mo, Manqiu Gao, Yunqing Deng, Ling Liang, Yuzhen Xia, Ning Pan, Ling |
author_sort | Mo, Manqiu |
collection | PubMed |
description | OBJECTIVE: Iron overload plays an important role in the pathogenesis of diabetes and acute kidney injury (AKI). The aim of this present study was to explore the relationship between iron metabolism and AKI in patients with diabetes. METHODS: The clinical data of diabetes patients from MIMIC-III database in intensive care unit (ICU) were retrospectively analyzed. Regression analyses were used to explore the risk factors of AKI and all-cause death in critical patients with diabetes. Area under the receiver operating characteristic curves (AUROCs) were used to analyze serum ferritin (SF), and regression model to predict AKI in critical patients with diabetes. All diabetes patients were followed up for survival at 6 months, and Kaplan–Meier curves were used to compare the survival rate in patients with different SF levels. RESULTS: A total of 4,997 diabetic patients in ICU were enrolled, with a male-to-female ratio of 1.37:1 and a mean age of 66.87 ± 12.74 years. There were 1,637 patients in the AKI group (32.8%) and 3,360 patients in the non-AKI group. Multivariate logistic regression showed that congestive heart failure (OR = 2.111, 95% CI = 1.320–3.376), serum creatinine (OR = 1.342, 95% CI = 1.192–1.512), Oxford Acute Severity of Illness Score (OR = 1.075, 95% CI = 1.045–1.106), increased SF (OR = 1.002, 95% CI = 1.001–1.003), and decreased transferrin (OR = 0.993, 95% CI = 0.989–0.998) were independent risk factors for AKI in critical patients with diabetes. Multivariate Cox regression showed that advanced age (OR = 1.031, 95% CI = 1.025–1.037), AKI (OR = 1.197, 95% CI = 1.011–1.417), increased Sequential Organ Failure Assessment score (OR = 1.055, 95% CI = 1.032–1.078), and increased SF (OR = 1.380, 95% CI = 1.038–1.835) were independent risk factors for 6-month all-cause death in critical diabetic patients. The AUROCs of SF and the regression model to predict AKI in critical patients with diabetes were 0.782 and 0.851, respectively. The Kaplan–Meier curve showed that the 6-month survival rate in SF-increased group was lower than that in SF-normal group (log-rank χ (2) = 16.989, P < 0.001). CONCLUSION: Critically ill diabetic patients with AKI were easily complicated with abnormal iron metabolism. Increase of SF is an important risk factor for AKI and all-cause death in critically ill patients with diabetes. |
format | Online Article Text |
id | pubmed-9098924 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-90989242022-05-14 Association Between Iron Metabolism and Acute Kidney Injury in Critically Ill Patients With Diabetes Mo, Manqiu Gao, Yunqing Deng, Ling Liang, Yuzhen Xia, Ning Pan, Ling Front Endocrinol (Lausanne) Endocrinology OBJECTIVE: Iron overload plays an important role in the pathogenesis of diabetes and acute kidney injury (AKI). The aim of this present study was to explore the relationship between iron metabolism and AKI in patients with diabetes. METHODS: The clinical data of diabetes patients from MIMIC-III database in intensive care unit (ICU) were retrospectively analyzed. Regression analyses were used to explore the risk factors of AKI and all-cause death in critical patients with diabetes. Area under the receiver operating characteristic curves (AUROCs) were used to analyze serum ferritin (SF), and regression model to predict AKI in critical patients with diabetes. All diabetes patients were followed up for survival at 6 months, and Kaplan–Meier curves were used to compare the survival rate in patients with different SF levels. RESULTS: A total of 4,997 diabetic patients in ICU were enrolled, with a male-to-female ratio of 1.37:1 and a mean age of 66.87 ± 12.74 years. There were 1,637 patients in the AKI group (32.8%) and 3,360 patients in the non-AKI group. Multivariate logistic regression showed that congestive heart failure (OR = 2.111, 95% CI = 1.320–3.376), serum creatinine (OR = 1.342, 95% CI = 1.192–1.512), Oxford Acute Severity of Illness Score (OR = 1.075, 95% CI = 1.045–1.106), increased SF (OR = 1.002, 95% CI = 1.001–1.003), and decreased transferrin (OR = 0.993, 95% CI = 0.989–0.998) were independent risk factors for AKI in critical patients with diabetes. Multivariate Cox regression showed that advanced age (OR = 1.031, 95% CI = 1.025–1.037), AKI (OR = 1.197, 95% CI = 1.011–1.417), increased Sequential Organ Failure Assessment score (OR = 1.055, 95% CI = 1.032–1.078), and increased SF (OR = 1.380, 95% CI = 1.038–1.835) were independent risk factors for 6-month all-cause death in critical diabetic patients. The AUROCs of SF and the regression model to predict AKI in critical patients with diabetes were 0.782 and 0.851, respectively. The Kaplan–Meier curve showed that the 6-month survival rate in SF-increased group was lower than that in SF-normal group (log-rank χ (2) = 16.989, P < 0.001). CONCLUSION: Critically ill diabetic patients with AKI were easily complicated with abnormal iron metabolism. Increase of SF is an important risk factor for AKI and all-cause death in critically ill patients with diabetes. Frontiers Media S.A. 2022-04-29 /pmc/articles/PMC9098924/ /pubmed/35574018 http://dx.doi.org/10.3389/fendo.2022.892811 Text en Copyright © 2022 Mo, Gao, Deng, Liang, Xia and Pan https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology Mo, Manqiu Gao, Yunqing Deng, Ling Liang, Yuzhen Xia, Ning Pan, Ling Association Between Iron Metabolism and Acute Kidney Injury in Critically Ill Patients With Diabetes |
title | Association Between Iron Metabolism and Acute Kidney Injury in Critically Ill Patients With Diabetes |
title_full | Association Between Iron Metabolism and Acute Kidney Injury in Critically Ill Patients With Diabetes |
title_fullStr | Association Between Iron Metabolism and Acute Kidney Injury in Critically Ill Patients With Diabetes |
title_full_unstemmed | Association Between Iron Metabolism and Acute Kidney Injury in Critically Ill Patients With Diabetes |
title_short | Association Between Iron Metabolism and Acute Kidney Injury in Critically Ill Patients With Diabetes |
title_sort | association between iron metabolism and acute kidney injury in critically ill patients with diabetes |
topic | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9098924/ https://www.ncbi.nlm.nih.gov/pubmed/35574018 http://dx.doi.org/10.3389/fendo.2022.892811 |
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