| Impact of glycemic control on the incidence of acute kidney injury in critically ill patients: a comparison of two strategies using the RIFLE criteria. | |
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MedLine Citation:
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PMID: 20835553 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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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 therapy or 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% of the patients and was associated with a higher mortality (39.4%) compared with those who did not have AKI (8.2%) (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. |
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Authors:
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José Raimundo Araújo de Azevedo; Renato Palácio de Azevedo; Lara Carneiro de Lucena; Nathalia de Nazaré Rabelo da Costa; Widlane Sousa da Silva |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinics (São Paulo, Brazil) Volume: 65 ISSN: 1980-5322 ISO Abbreviation: Clinics (Sao Paulo) Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-09-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101244734 Medline TA: Clinics (Sao Paulo) Country: Brazil |
Other Details:
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Languages: eng Pagination: 769-73 Citation Subset: IM |
Affiliation:
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Intensive Care Units of São Domingos Hospital, Dr Clementino Moura Hospital, São Luis, MA, Brazil. jrazevedo@elo.com.br |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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