Acute Hyperglycemia

Turcot, Diane; Kiernan, Francis J.; McKay, Raymond G.; Grey, Neil; Boden, William E.; Perdrizet, George A.

doi:10.2337/diacare.27.2.620

Cited by 15 publications

(11 citation statements)

References 5 publications

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“…On the other hand, hypertension is also a common cause of CKD and it can be found in 80% of patients with diabetic nephropathy [6,68,70,71]. The incidence of CIN is also higher in patients with diffuse atherosclerotic disease, such as peripheral vascular disease [21,68,69] and previous stroke or myocardial infarction [6]. The role of dyslipidemia in the development of CIN is not clear.…”

Section: Risk Factors For Cinmentioning

confidence: 99%

“…A recent observational prospective study showed that acute hyperglycemia represents a risk factor for CIN. In this study of diabetic patients, CIN occurred in 8 out of 19 patients (42%) with hyperglycemia and in 1 out of 19 patients (5.3%) with normal glycemia at the moment of PCI [69]. So it seems to be important to manage blood glucose levels in the periprocedural time.…”

Section: Risk Factors For Cinmentioning

confidence: 99%

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Contrast-Induced Nephropathy in Percutaneous Coronary Interventions: Pathogenesis, Risk Factors, Outcome, Prevention and Treatment

Aurelio¹,

Durante²

2014

Cardiology

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Contrast-induced nephropathy (CIN) is a well-known adverse event of therapeutic and diagnostic procedures requiring the adminstration of contrast medium (CM). The lack of a universal CIN definition and glomerular filtration rate markers that vary have resulted in a variety of reported incidences. The development of CIN is associated with an increase in the length of hospital stay and the risk of death. Preexisting renal dysfunction, age, diabetes, congestive heart failure and the volume of CM administered are all associated with a risk for developing CIN. The literature suggests the use of low-osmolarity CM and supports volume supplementation before administration. Moreover, other strategies to avoid CIN, including treatment with N-acetylcisteine and sodium bicarbonate have variable levels of evidence. This review examines the main components of the pathogenesis and risk factors of CIN and possible preventive measures and therapies.

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Section: Risk Factors For Cinmentioning

confidence: 99%

Section: Risk Factors For Cinmentioning

confidence: 99%

Contrast-Induced Nephropathy in Percutaneous Coronary Interventions: Pathogenesis, Risk Factors, Outcome, Prevention and Treatment

Aurelio¹,

Durante²

2014

Cardiology

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“…Elevated glucose levels upon hospital admission (acute hyperglycemia) are a common finding known to have a detrimental effect on the outcome of STEMI [11,12,13] patients, even in the absence of established diabetes mellitus (DM). Although previous studies have shown that elevated glucose levels increase the risk of contrast-induced nephropathy in patients undergoing elective PCI [14,15], only limited data exist regarding the effect of hyperglycemia on AKI in STEMI patients undergoing primary PCI and its relation to the absence of known DM. In the present study, we evaluated the association of admission glucose levels with the occurrence of AKI in a large cohort of consecutive nondiabetic STEMI patients treated with primary PCI.…”

Section: Introductionmentioning

confidence: 99%

Admission Glucose Levels and the Risk of Acute Kidney Injury in Nondiabetic ST Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

Shacham¹,

Gal‐Oz

Leshem³

et al. 2015

Cardiorenal Med

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Background: Hyperglycemia upon admission is associated with an increased risk for acute kidney injury (AKI) in ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). However, the relation of this association to the absence of diabetes mellitus (DM) is less studied. We evaluated the effect of acute hyperglycemia levels on the risk of AKI among STEMI patients without DM who were all treated with primary PCI. Methods: We retrospectively studied 1,065 nondiabetic STEMI patients undergoing primary PCI. Patients were stratified according to admission glucose levels into normal (<140 mg/dl), mild (140-200 mg/dl), and severe (>200 mg/dl) hyperglycemia groups. Medical records were reviewed for the occurrence of AKI. Results: The mean age was 61 ± 13 years and 81% were males. Hyperglycemia upon hospital admission was present in 402 of 1,065 patients (38%). Patients with severe admission hyperglycemia had a significantly higher rate of AKI compared to patients with no or mild hyperglycemia (20 vs. 7 and 8%, respectively; p = 0.001) and had a significantly greater serum creatinine change throughout hospitalization (0.17 vs. 0.09 and 0.07 mg/dl, respectively; p = 0.04). In multivariate logistic regression, severe hyperglycemia emerged as an independent predictor of AKI (OR = 2.46, 95% CI 1.16-5.28; p = 0.018). Conclusion: Severe admission hyperglycemia is an independent risk factor for the development of AKI among nondiabetic STEMI patients undergoing primary PCI.

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“…10 Hyperglycemia and insulin resistance are also common in critically ill patients, even in those without diabetes, 11,12 and are associated with increased morbidity and mortality. [13][14][15][16][17][18][19] Observational trials, after correction for diabetes and other known risk factors, have shown an association between pre-or intraoperative hyperglycemia and postoperative AKI after cardiac surgery, 20,21 between hyperglycemia at cardiac catheterization and contrast nephropathy, 22 and between hyperglycemia during total parenteral nutrition and the development of AKI. 23 Whether the degree of hyperglycemia simply reflects the severity of illness or is actually contributing to the adverse renal outcome can be demonstrated only by a randomized trial comparing correction or tolerance of the elevated blood glucose levels.…”

mentioning

confidence: 99%

Tight Blood Glucose Control Is Renoprotective in Critically Ill Patients

Schetz

Vanhorebeek²,

Wouters³

et al. 2008

Journal of the American Society of Nephrology

134

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Two large, prospective, randomized, controlled trials have shown a beneficial effect of intensive insulin therapy (IIT) on the kidney function of critically ill patients. The data from these trials were combined for performance of a more detailed analysis of the renoprotective effect of IIT. After exclusion of 41 patients with preadmission ESRD, the study sample comprised 2707 critically ill patients who were randomly assigned to conventional or IIT. A modified risk-injury-failure-loss-ESRD (mRIFLE) system was used to classify acute kidney injury such that mRIFLE-Injury and -Failure (mR-IF) corresponded to peak serum creatinine levels Ն2ϫ and Ն3ϫ the admission levels, respectively. IIT significantly reduced the incidence of mR-I or -F from 7.6 to 4.5% (P ϭ 0.0006), and this renoprotective effect was most pronounced in patients who achieved strict normoglycemia. In surgical patients, IIT also significantly reduced oliguria (from 5.6 to 2.6%; P ϭ 0.004) and the need for renal replacement therapy (from 7.4 to 4.0%; P ϭ 0.008). In medical patients, the incidence of mR-I or -F decreased to a lesser extent, perhaps because a greater severity of illness at admission may have rendered preventive therapies less effective. In conclusion, this secondary analysis of two large, randomized, controlled trials suggests that IIT, with a goal of achieving normoglycemia, protects the renal function of critically ill patients.

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Acute Hyperglycemia

Abstract: Characteristics of patients with type 2 diabetes in Mexico: results from a large populationbased nationwide survey.

Cited by 15 publications

References 5 publications

Contrast-Induced Nephropathy in Percutaneous Coronary Interventions: Pathogenesis, Risk Factors, Outcome, Prevention and Treatment

Contrast-Induced Nephropathy in Percutaneous Coronary Interventions: Pathogenesis, Risk Factors, Outcome, Prevention and Treatment

Admission Glucose Levels and the Risk of Acute Kidney Injury in Nondiabetic ST Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

Tight Blood Glucose Control Is Renoprotective in Critically Ill Patients

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