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Admission Glucose Levels and the Risk of Acute Kidney Injury in Nondiabetic ST Segment Elevation Myocardial

Yacov Shacham1, Amir Gal-Oz2, Eran Leshem-Rubinow1

  • 1Department of Cardiology, Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Cardiorenal Medicine
|July 22, 2015
PubMed

Insights

Severe hyperglycemia on admission increases acute kidney injury (AKI) risk in non-diabetic ST-elevation myocardial infarction (STEMI) patients. This finding highlights the importance of glucose control in STEMI patients without diabetes undergoing primary PCI.

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology

Background:

  • Hyperglycemia at admission is linked to acute kidney injury (AKI) in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).
  • The association between hyperglycemia and AKI in STEMI patients without diabetes is less understood.
  • This study investigates acute hyperglycemia's impact on AKI risk in nondiabetic STEMI patients treated with primary PCI.

Purpose of the Study:

  • To evaluate the effect of admission hyperglycemia levels on the risk of AKI.
  • To determine if severe hyperglycemia is an independent predictor of AKI in this specific patient group.

Main Methods:

  • Retrospective analysis of 1,065 nondiabetic STEMI patients who underwent primary PCI.
  • Stratification of patients into normal (<140 mg/dl), mild (140-200 mg/dl), and severe (>200 mg/dl) admission glucose groups.
  • Review of medical records for AKI occurrence and serum creatinine changes.

Main Results:

  • 38% of patients had hyperglycemia on admission.
  • Severe admission hyperglycemia was associated with a significantly higher AKI rate (20% vs. 7-8%; p=0.001).
  • Severe hyperglycemia independently predicted AKI (OR=2.46, p=0.018) and was linked to greater serum creatinine changes.

Conclusions:

  • Severe admission hyperglycemia is an independent risk factor for AKI development.
  • This risk is present in nondiabetic STEMI patients undergoing primary PCI.
  • Admission glucose levels are crucial for assessing AKI risk in these patients.
Abstract

Keywords:
Acute kidney injuryAcute myocardial infarctionDiabetes mellitusHyperglycemia

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