Photo Credit: Mohammed Haneefa Nizamudeen

The following is a summary of “Association between glycemic variability and short-term mortality in patients with acute kidney injury: a retrospective cohort study of the MIMIC-IV database,” published in the March 2024 issue of Nephrology by Guo et al.

Acute kidney injury (AKI) is regarded as a substantial global public health challenge that often leads to an unfavorable outcome. The impact of mean blood glucose (MBG) and coefficient of variation (CV) of blood glucose on short-term mortality among AKI patients remains a subject of ongoing debate. 

Researchers conducted a retrospective study to investigate the link between glycemic variability and short-term mortality among AKI patients.

They examined data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, comprising 6,777 adult AKI patients. MBG and CV on the initial day of ICU admission were computed to reflect the overall glycemic condition and variability throughout the ICU stay in AKI patients. The primary endpoint assessed was the 30-day ICU mortality rate among AKI patients.

The results showed that the ICU 30-day mortality rate for AKI patients was 23.5%. Multivariate Cox regression analysis and smoothed curve fitting revealed a significant association between blood glucose levels and mortality. Increased MBG and CV were significantly correlated with ICU 30-day mortality (HR = 1.20, 95% CI 1.14–1.27; HR = 1.08, 95% CI 1.03–1.13). The smoothed curve fitting demonstrated a U-shaped relationship between MBG on the first day of ICU admission and ICU 30-day mortality, with an inflection point at 111.3 mg/dl, while CV exhibited a linear relationship with 30-day ICU mortality.

Investigators concluded that tighter blood sugar control (MBG and CV) in ICU patients with AKI is linked to better short-term survival.

Source: nature.com/articles/s41598-024-56564-7