Combined stress hyperglycemia ratio and glycemic variability phenotypes with severe acute kidney injury after cardiac surgery across glucose metabolic states

Combined stress hyperglycemia ratio and glycemic variability phenotypes with severe acute kidney injury after cardiac surgery across glucose metabolic states. Download PDF Abstract Stress hyperglycemia ratio (SHR) and glycemic variability (GV) capture different aspects of acute glycemic disturbance, but their joint association with severe acute kidney injury (AKI) after cardiac surgery remains unclear. This retrospective MIMIC-IV cohort included adults undergoing cardiac surgery.

GV was calculated from exactly the first three routinely collected glucose measurements obtained within 24 h after ICU admission; patients developing severe AKI during this period were excluded. Tertile-based SHR and GV thresholds defined four phenotypes. Severe AKI after 24 h was identified using serum creatinine and renal replacement therapy criteria.

Multivariable regression, interaction, spline, and sensitivity analyses were performed. Among 2475 patients, 336 developed severe AKI. Neither SHR nor GV alone was independently associated with severe AKI.

Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with qualified healthcare professionals for medical decisions and treatment options.