The Impact of Diabetes Mellitus on Acute Kidney Injury after Coronary Artery Bypass Grafting

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background:</jats:bold> Diabetes mellitus(DM) is an indicator affects postoperative mortality and morbidity after coronary artery bypass grafting (CABG). Acute kidney injury (AKI) is one of the frequent postoperative complications after CABG. This multi-centre register study designed to investigate the impact of DM on postoperative AKI in primary isolated CABG patients. <jats:bold>Methods: </jats:bold>We included all patients (n =4325) from Jiangsu Province CABG register who underwent primary isolated CABG from September 2017 to August 2019. The patients were divided into 3 groups: A group(non-DM, n=3067), B group(DM with oral hypoglycemic agents, n=706) and C group(DM with insulin treatment, n=552). The development and severity of AKI were based on Acute Kidney Injury Network (AKIN) criteria.<jats:bold> </jats:bold><jats:bold>Results: </jats:bold>There were totally 338, 108 and 145 patients developed AKI in A,B and C group respectively. Comparing with A group , B group had a higher rate of AKI(c<jats:sup>2</jats:sup>=10.071, p=0.002), C group had a higher rate(c<jats:sup>2</jats:sup>=94.042, p＜0.001) and severity of AKI(c<jats:sup>2</jats:sup>=10.649, p=0.005). The adjusted odds ratio for AKI was 1.26 (95% CI 1.03-1.57) in B group and 3.92 (95% CI 3.27-5.16) in C group, in comparison with A group. <jats:bold>Conclusions: </jats:bold>Independent of baseline renal function or cardiac function, DM was associated with an increased risk of AKI after CABG, especially in patients with insulin treatment, who also had a higher severity of AKI.</jats:p>

The Effect of Preoperative and Postoperative Glycemic Control on Acute Kidney Injury After Off-Pump Coronary Artery Bypass Grafting: A Case-Control Study

“…Therefore, increased insulin usage means higher blood glucose levels. This is consistent with the conclusion of previous research [Kogan 2018;Li 2015;Munnee 2016;Wang 2020;Ram 2020]. This is similar to the worse prognosis of patients with the high-dose inotropic drug.…”