Evaluation of Early Postoperative Period Results of Patients With Type 2 Diabetes Taking Oral Anti-Diabetics Or Insulin Medications, With Microalbuminuria and Normal Creatinine Levels After Coronary Artery Bypass.

H. Gemalmaz, C. Yücel
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引用次数: 1

Abstract

BACKGROUND Acute kidney injury (AKI) is one of the most important complications after cardiac surgery and is one of the main causes of morbidity and mortality. Diabetes mellitus also is one of the main risk factors for renal dysfunction in coronary artery bypass graft (CABG). In this study, we aimed to compare the early postoperative period results of type 2 diabetes patients taking oral antidiabetics (OAD) or insulin medications, with microalbuminuria and normal creatinine levels after CABG. METHODS Eighty patients with type 2 diabetes and taking OAD or receiving insulin medication all with normal creatinine levels with microalbuminuria were included in this study. Preoperative creatinine values of the patients, albumin levels in spot urine, creatinine levels on the postoperative 3rd day, duration of ventilation, amount of drainage, length of stay in the intensive care unit, length of stay in the hospital, mediastinitis, and mortality rates were recorded. RESULTS A statistically significant increase in creatinine was found in both taking OAD type 2 diabetes and insulin medication with microalbuminuria. When the two groups were compared with each other, the increase in creatinine levels of the patients using insulin was higher than the patients taking OAD. It also was statistically significant. CONCLUSION According to the result of our study, it can be suggested that postoperative creatinine elevation is observed in patients with type 2 diabetes mellitus with microalbuminuria and with normal creatinine levels, either having insulin medication or not. The elevation is higher in patients having insulin medication, while other results are similar, except for impaired renal function.
2型糖尿病患者冠状动脉搭桥术后微量白蛋白尿和肌酐水平正常且口服抗糖尿病或胰岛素药物术后早期结果的评价
背景:急性肾损伤(AKI)是心脏手术后最重要的并发症之一,也是导致发病率和死亡率的主要原因之一。糖尿病也是冠状动脉搭桥术后肾功能不全的主要危险因素之一。在本研究中,我们旨在比较2型糖尿病患者术后早期服用口服抗糖尿病药物(OAD)或胰岛素药物,与CABG术后微量白蛋白尿和正常肌酐水平的结果。方法选取80例肌酐水平正常且同时服用OAD或胰岛素治疗的2型糖尿病患者,并合并微量白蛋白尿。记录患者术前肌酐值、斑点尿白蛋白水平、术后第3天肌酐水平、通气时间、引流量、重症监护病房住院时间、住院时间、纵隔炎、死亡率。结果OAD 2型糖尿病患者及胰岛素治疗伴微量白蛋白尿患者肌酐升高均有统计学意义。两组相互比较,胰岛素组肌酐水平升高高于OAD组。这在统计学上也是显著的。结论根据我们的研究结果,提示2型糖尿病合并微量白蛋白尿患者术后肌酐水平升高,且肌酐水平正常,无论是否使用胰岛素治疗。接受胰岛素治疗的患者血糖升高更高,而除了肾功能受损外,其他结果相似。
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