1型和2型糖尿病与冠状动脉搭桥术后急性肾损伤风险
Type 1 and type 2 diabetes mellitus and risk of acute kidney injury after coronary artery bypass grafting.
作者信息
Hertzberg Daniel, Sartipy Ulrik, Holzmann Martin J
机构信息
Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Anesthesiology, Surgical Services and Intensive Care Medicine, Karolinska University Hospital, Stockholm, Sweden.
Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
出版信息
Am Heart J. 2015 Nov;170(5):895-902. doi: 10.1016/j.ahj.2015.08.013. Epub 2015 Aug 20.
BACKGROUND
Our objective was to investigate the association between type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and acute kidney injury (AKI) in patients who underwent coronary artery bypass grafting (CABG).
METHODS
We included all patients (n = 36,106) from the SWEDEHEART register who underwent primary isolated CABG in Sweden from 2003 to 2013. Information on type of diabetes was retrieved from the Swedish National Diabetes Register. Acute kidney injury was defined as an absolute increase by 0.3 mg/dL (26 μmol/L) or a relative increase by at least 50% in postoperative serum creatinine compared with preoperative levels. Odds ratios with 95% CIs for AKI in patients with T1DM and T2DM were compared with those patients without diabetes using logistic regression.
RESULTS
In total, there were 457 patients (1.3%) with T1DM and 5124 (14%) with T2DM. Among patients with T1DM and T2DM, 145 (32%) and 1037 (20%), respectively, developed AKI, compared with 4017 (13%) in patients without diabetes. The adjusted odds ratio for AKI was 4.89 (95% CI 3.82-6.25) in patients with T1DM and 1.27 (95% CI 1.16-1.40) in patients with T2DM, in comparison with patients without diabetes.
CONCLUSIONS
Both T1DM and T2DM were associated with an increased risk of AKI after CABG. The risk was markedly higher in patients with T1DM than in those with T2DM and was independent of preoperative renal function.
背景
我们的目的是研究接受冠状动脉搭桥术（CABG）的患者中1型糖尿病（T1DM）、2型糖尿病（T2DM）与急性肾损伤（AKI）之间的关联。
方法
我们纳入了瑞典SWEDEHEART注册中心2003年至2013年期间在瑞典接受初次单纯CABG的所有患者（n = 36,106）。糖尿病类型信息从瑞典国家糖尿病注册中心获取。急性肾损伤定义为术后血清肌酐较术前水平绝对升高0.3 mg/dL（26 μmol/L）或相对升高至少50%。使用逻辑回归比较T1DM和T2DM患者与无糖尿病患者发生AKI的比值比及95%置信区间。
结果
总共有457例（1.3%）T1DM患者和5124例（14%）T2DM患者。在T1DM和T2DM患者中，分别有145例（32%）和1037例（20%）发生AKI，而无糖尿病患者中有4017例（13%）发生AKI。与无糖尿病患者相比，T1DM患者发生AKI的校正比值比为4.89（95%置信区间3.82 - 6.25），T2DM患者为1.27（95%置信区间1.16 - 1.40）。
结论
T1DM和T2DM均与CABG术后AKI风险增加相关。T1DM患者的风险明显高于T2DM患者，且独立于术前肾功能。
Zotero 插件