The impact of acute kidney injury in diabetes mellitus.

BACKGROUND

Little data exist on outcome of acute kidney injury (AKI) in diabetes. We describe short-term recovery of renal function, patient mortality and progressive renal dysfunction following AKI in diabetic patients.

METHODS

Using the diagnosis of either diabetes or no diabetes as the defining variable, AKI episodes were identified from records of a clinical biochemistry department serving a population of 560 000. Patient co-morbidity and mortality were collated from electronic patient records. Outcomes were compared with a non-diabetic cohort with AKI.

RESULTS

Acute kidney injury was identified in 101 diabetic and 392 non-diabetic patients. Patients with diabetes had less severe AKI, compared with the non-diabetic cohort (AKI stage 1 76% vs 55%, P = 0.0006). Overall acute mortality, and mortality adjusted for co-morbidity, was comparable in the diabetic and non-diabetic groups. Recovery to baseline renal function was greater in diabetic patients (87% vs 63% P = 0.001), and the proportion of patients developing progressive chronic kidney disease was lower in the (14%) compared with the non-diabetic cohort (48%, P < 0.00001).

CONCLUSIONS

Although acute mortality is comparable following an AKI episode in diabetic patients compared with that associated with AKI in a non-diabetic cohort, for those surviving the acute episode, its impact on renal function is significantly less than in a non-diabetic group.