Related Experiment Video
Updated: Oct 7, 2025
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
19.0K
Hyperglycemia on Admission Predicts Acute Kidney Failure and Renal Functional Recovery among Inpatients
Yuri Gorelik1,2, Natalie Bloch-Isenberg1,2, Siwar Hashoul2,3
1Department of Medicine D, Rambam Health Care Campus, Haifa 3109601, Israel.
Journal of Clinical Medicine
|January 11, 2022
Summary
High blood glucose on admission increases risks for hospitalized patients, particularly non-diabetics. This study found hyperglycemia linked to acute kidney injury, kidney function recovery, and mortality, with effects lessening in diabetic individuals.
Area of Science:
- Nephrology
- Endocrinology
- Internal Medicine
Background:
- Hyperglycemia (high blood glucose) is a known risk factor for adverse outcomes in hospitalized patients.
- The impact of admission glucose levels on kidney function changes and clinical outcomes requires further investigation, especially concerning diabetes and baseline kidney function.
- Understanding these associations can inform patient management and improve outcomes.
Purpose of the Study:
- To assess the effect of admission glucose levels on subsequent kidney function (deterioration or improvement) in hospitalized patients.
- To investigate the modifying role of diabetes and baseline kidney function on the relationship between hyperglycemia and clinical outcomes.
- To determine the association between admission glucose levels and outcomes such as acute kidney injury (AKI), acute kidney functional recovery (AKR), and mortality.
Main Methods:
- Retrospective cohort analysis comparing patients with normal versus high glucose levels upon admission.
- Multivariable logistic regression models were used to analyze the association between baseline glucose and renal/clinical outcomes.
- Interaction terms were incorporated to examine the potential modifying effect of diabetes.
Main Results:
- The study included 95,556 inpatients; 16.5% had plasma glucose >180 mg/dL, with 72% being diabetic.
- Higher admission glucose was associated with older age and more comorbidities.
- Rates of AKI, AKR, and mortality were proportional to reduced renal function and nearly doubled in patients with high baseline glucose.
- Multivariable analysis indicated an increasing probability of adverse events with higher glucose, primarily in non-diabetic patients.
Conclusions:
- Hyperglycemia is linked to AKI, AKR, and mortality in non-diabetic inpatients, with risk escalating with illness severity.
- The association between hyperglycemia and adverse outcomes is less pronounced in diabetic patients.
- This suggests that renal derangements in diabetic patients may be more treatable and reversible.
Related Concept Videos
01:20Acute Kidney Injury V: Interprofessional Care
65
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
65
01:22Acute Kidney Injury I: Introduction
125
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
125
01:29Acute Kidney Injury III: Clinical Manifestations
148
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
148
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
76
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
76
01:22Acute Kidney Injury VI: Nursing Management
102
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
102
01:29Acute Kidney Injury II: Pathophysiology
147
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
147