糖尿病和非糖尿病足部感染患者急性肾损伤的发生率和恢复情况。

Incidence and Recovery of Acute Kidney Injury in Diabetic and Nondiabetic Patients with Foot Infections.

机构信息

*University of Texas Southwestern Medical School, Dallas, TX.

†Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX.

出版信息

J Am Podiatr Med Assoc. 2022 Nov-Dec;112(6). doi: 10.7547/20-167.

DOI:10.7547/20-167

PMID:33141881

Abstract

BACKGROUND

The aim of this study was to evaluate the incidence and recovery of acute kidney injury (AKI) in patients admitted to the hospital with and without diabetes mellitus (DM) with foot infections.

METHODS

We retrospectively reviewed 294 patients with DM and 88 without DM admitted to the hospital with foot infections. The Kidney Disease: Improving Global Outcomes guidelines were used to define AKI. Recovery was divided into three categories: full, partial, and no recovery within 90 days of the index AKI.

RESULTS

The AKI incidence was 3.0 times higher in patients with DM (DM 48.5% versus no DM 23.9%; 95% confidence interval [CI], 1.74-5.19; P < .01). Acute kidney injury incidence was similar at each stage in people with and without DM (stage 1, DM 58.1% versus no DM 47.6%; stage 2, DM 23.3% versus no DM 33.3%, and stage 3, DM 18.6% versus no DM 19.1%). Twenty-nine patients with diabetes had a second AKI event and four had a third event. In patients without DM, one patient had a second AKI. Cumulative AKI incidence was 4.7 times higher in people with DM (DM 60.9% versus no DM 25.0%; 95% CI, 2.72-8.03; P < .01). Patients with diabetes progressed to chronic kidney disease or in chronic kidney disease stage 39.4% of the time. Patients without diabetes progressed 16.7% of the time, but this trend was not significant (P = .07). Complete recovery was 3.8 times more likely in patients without diabetes (95% CI, 1.26-11.16; P = .02).

CONCLUSIONS

Acute kidney injury incidence is higher in patients with diabetes, and complete recovery after an AKI is less likely compared to patients without diabetes.

摘要

背景

本研究旨在评估患有和不患有糖尿病（DM）的足部感染住院患者中急性肾损伤（AKI）的发生率和恢复情况。

方法

我们回顾性分析了 294 例 DM 患者和 88 例非 DM 足部感染住院患者。采用肾脏病：改善全球预后组织指南定义 AKI。恢复分为完全、部分和 90 天内无恢复 3 个类别。

结果

DM 患者 AKI 发生率高 3 倍（DM 组 48.5%，非 DM 组 23.9%；95%置信区间[CI]，1.74-5.19；P <.01）。有和无 DM 患者 AKI 各期发生率相似（1 期 DM 组 58.1%，非 DM 组 47.6%；2 期 DM 组 23.3%，非 DM 组 33.3%；3 期 DM 组 18.6%，非 DM 组 19.1%）。29 例 DM 患者发生第 2 次 AKI，4 例发生第 3 次 AKI。非 DM 患者中 1 例发生第 2 次 AKI。DM 患者 AKI 累积发生率高 4.7 倍（DM 组 60.9%，非 DM 组 25.0%；95%CI，2.72-8.03；P <.01）。DM 患者进展为慢性肾脏病或慢性肾脏病 3 期的比例为 9.4%，非 DM 患者进展为慢性肾脏病或慢性肾脏病 3 期的比例为 16.7%，但差异无统计学意义（P =.07）。无糖尿病患者完全恢复的可能性高 3.8 倍（95%CI，1.26-11.16；P =.02）。