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
Dans Anglais
| 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.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Indice de gravité de la maladie
/
Glycémie
/
Atteinte rénale aigüe
/
Unités de soins intensifs
Type d'étude:
Etude d'incidence
/
Étude observationnelle
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Femelle
/
Humains
/
Mâle
Pays comme sujet:
Amérique du Sud
/
Brésil
langue:
Anglais
Texte intégral:
Clinics
Thème du journal:
Médicament
Année:
2010
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Dr. Clementino Moura Hospital/BR
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