Predictive value of stress hyperglycemia ratio on one-year mortality in chronic kidney disease patients admitted to intensive care unit.

IF 2.2 4区 医学 Q2 UROLOGY & NEPHROLOGY
Shuoyan An, Zixiang Ye, Wuqiang Che, Yanxiang Gao, Jingyi Ren, Jiahui Li, Jingang Zheng
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Abstract

Background: Stress Hyperglycemia Ratio (SHR) reflects the acute blood glucose variation in critically ill conditions. However, its prognostic value in chronic kidney disease (CKD) remains understudied. This study aimed to investigate the association between SHR and one-year mortality in CKD patients hospitalized in the Intensive Care Unit (ICU).

Methods: Patients with diagnosis of CKD in the Medical Information Mart for Intensive Care IV (MIMIC-IV) database were enrolled. Incidence of all-cause mortality within one-year follow-up was used as the primary endpoint.

Results: 1825 CKD patients were included in the study. A "U-shaped" relationship between SHR and one-year mortality as identified using multivariate restricted cubic spline (RCS) analysis. Then study population were categorized into three groups: Group 1 (SHR < 0.70), Group 2 (0.70 ≤ SHR ≤ 0.95) and Group 3 (SHR > 0.95). Group 2 showed significantly better one-year outcomes compared to the other two groups (p = 0.0031). This survival benefit persisted across subgroup analyses stratified by age, sex, CKD stage, anemia and various clinical conditions.

Conclusion: SHR proved to be a meaningful biomarker for predicting one-year mortality in ICU-admitted CKD patients, with a "U-shaped" correlation. The identification of the optimal SHR range (0.70-0.95) provided clinicians with a valuable tool for detecting high-risk populations.

压力性高血糖比率对重症监护室慢性肾病患者一年死亡率的预测价值。
背景:应激性高血糖比值(SHR)反映了危重病人的急性血糖变化。然而,其在慢性肾脏病(CKD)中的预后价值仍未得到充分研究。本研究旨在调查在重症监护室(ICU)住院的 CKD 患者的 SHR 与一年死亡率之间的关系:方法:研究人员招募了重症监护医学信息市场(MIMIC-IV)数据库中诊断为 CKD 的患者。结果:1825 名 CKD 患者被纳入 MIMIC-IV 数据库:研究共纳入了 1825 名慢性肾脏病患者。通过多变量限制立方样条曲线(RCS)分析发现,SHR与一年死亡率之间存在 "U "型关系。随后,研究对象被分为三组:第 1 组(SHR 0.95)。与其他两组相比,第 2 组的一年生存率明显更高(p = 0.0031)。根据年龄、性别、慢性肾脏病分期、贫血和各种临床状况进行亚组分析后,这种生存获益依然存在:事实证明,SHR 是预测入住 ICU 的 CKD 患者一年死亡率的有效生物标志物,其相关性呈 "U "形。最佳 SHR 范围(0.70-0.95)的确定为临床医生检测高危人群提供了宝贵的工具。
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来源期刊
BMC Nephrology
BMC Nephrology UROLOGY & NEPHROLOGY-
CiteScore
4.30
自引率
0.00%
发文量
375
审稿时长
3-8 weeks
期刊介绍: BMC Nephrology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of kidney and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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