Impact of glycemic control on the incidence of acute kidney injury in critically ill patients: a comparison of two strategies using the RIFLE criteria
Clinics
;
65(8): 769-773, June 2010. tab
Article
in English
| LILACS
| ID: lil-557002
ABSTRACT
OBJECTIVE: To compare the renal outcome in patients submitted to two different regimens of glycemic control, using the RIFLE criteria to define acute kidney injury. INTRODUCTION: The impact of intensive insulin therapy on renal function outcome is controversial. The lack of a criterion for AKI definition may play a role on that. METHODS: Included as the subjects were 228 randomly selected, critically ill patients engaged in intensive insulin therapyor in a carbohydrate-restrictive strategy. Renal outcome was evaluated through the comparison of the last RIFLE score obtained during the ICU stay and the RIFLE score at admission; the outcome was classified as favorable, stable or unfavorable. RESULTS: The two groups were comparable regarding demographic data. AKI developed in 52 percent of the patients and was associated with a higher mortality (39.4 percent) compared with those who did not have AKI (8.2 percent) (p<0.001). Renal function outcome was comparable between the two groups (p=0.37). We observed a significant correlation between blood glucose levels and the incidence of acute kidney injury (p=0.007). In the multivariate logistic regression analysis, only APACHE III scores higher than 60 were identified as an independent risk factor for unfavorable renal outcome. APACHE III scores>60, acute kidney injury and hypoglycemia were risk factors for mortality. CONCLUSION: Intensive insulin therapy and a carbohydrate-restrictive strategy were comparable regarding the incidence of acute kidney injury evaluated using RIFLE criteria.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Severity of Illness Index
/
Blood Glucose
/
Acute Kidney Injury
/
Intensive Care Units
Type of study:
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Female
/
Humans
/
Male
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2010
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Dr. Clementino Moura Hospital/BR
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