Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus

Purpose: To evaluate the role of diabetes mellitus in the incidence, risk factors, and outcomes of AKI (acute kidney injury) in patients admitted with ACS (acute coronary syndrome). Methods: We performed a comparative evaluation of ACS patients with vs. without DM who developed AKI enrolled in the b...

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Autores principales:	Arthur Shiyovich, Keren Skalsky, Tali Steinmetz, Tal Ovdat, Alon Eisen, Abed Samara, Roy Beigel, Sagi Gleitman, Ran Kornowski, Katia Orvin
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	acute kidney injury diabetes mellitus acute coronary syndrome Medicine R
Acceso en línea:	https://doaj.org/article/03219a25e8dc4b5f8acc32420a0746f1
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spelling	oai:doaj.org-article:03219a25e8dc4b5f8acc32420a0746f12021-11-11T17:34:07ZAcute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus10.3390/jcm102149312077-0383https://doaj.org/article/03219a25e8dc4b5f8acc32420a0746f12021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4931https://doaj.org/toc/2077-0383Purpose: To evaluate the role of diabetes mellitus in the incidence, risk factors, and outcomes of AKI (acute kidney injury) in patients admitted with ACS (acute coronary syndrome). Methods: We performed a comparative evaluation of ACS patients with vs. without DM who developed AKI enrolled in the biennial ACS Israeli Surveys (ACSIS) between 2000 and 2018. AKI was defined as an absolute increase in serum creatinine (≥0.5 mg/dL) or above 1.5 mg/dL or new renal replacement therapy upon admission with ACS. Outcomes included 30-day major adverse cardiovascular events (MACE) and 1-year all-cause mortality. Results: The current study included a total of 16,879 patients, median age 64 (IQR 54–74), 77% males, 36% with DM. The incidence of AKI was significantly higher among patients with vs. without DM (8.4% vs. 4.7%, <i>p</i> < 0.001). The rates of 30-day MACE (40.8% vs. 13.4%, <i>p</i> < 0.001) and 1-year mortality (43.7% vs. 10%, <i>p</i> < 0.001) were significantly greater among diabetic patients who developed vs. those who did not develop AKI respectively, yet very similar among patients that developed AKI with vs. without DM (30-day MACE 40.8% vs. 40.3%, <i>p</i> = 0.9 1-year mortality 43.7 vs. 44.8%, <i>p</i> = 0.8, respectively). Multivariate analyses adjusted to potential confounders, showed similar independent predictors of AKI among patients with and without DM, comprising; older age, chronic kidney disease, congestive heart failure, and peripheral arterial disease. Conclusions: Although patients with DM are at much greater risk for AKI when admitted with ACS, the independent predictors of AKI and the worse patient outcomes when AKI occurs, are similar irrespective to DM status.Arthur ShiyovichKeren SkalskyTali SteinmetzTal OvdatAlon EisenAbed SamaraRoy BeigelSagi GleitmanRan KornowskiKatia OrvinMDPI AGarticleacute kidney injurydiabetes mellitusacute coronary syndromeMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4931, p 4931 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute kidney injury diabetes mellitus acute coronary syndrome Medicine R
spellingShingle	acute kidney injury diabetes mellitus acute coronary syndrome Medicine R Arthur Shiyovich Keren Skalsky Tali Steinmetz Tal Ovdat Alon Eisen Abed Samara Roy Beigel Sagi Gleitman Ran Kornowski Katia Orvin Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus
description	Purpose: To evaluate the role of diabetes mellitus in the incidence, risk factors, and outcomes of AKI (acute kidney injury) in patients admitted with ACS (acute coronary syndrome). Methods: We performed a comparative evaluation of ACS patients with vs. without DM who developed AKI enrolled in the biennial ACS Israeli Surveys (ACSIS) between 2000 and 2018. AKI was defined as an absolute increase in serum creatinine (≥0.5 mg/dL) or above 1.5 mg/dL or new renal replacement therapy upon admission with ACS. Outcomes included 30-day major adverse cardiovascular events (MACE) and 1-year all-cause mortality. Results: The current study included a total of 16,879 patients, median age 64 (IQR 54–74), 77% males, 36% with DM. The incidence of AKI was significantly higher among patients with vs. without DM (8.4% vs. 4.7%, <i>p</i> < 0.001). The rates of 30-day MACE (40.8% vs. 13.4%, <i>p</i> < 0.001) and 1-year mortality (43.7% vs. 10%, <i>p</i> < 0.001) were significantly greater among diabetic patients who developed vs. those who did not develop AKI respectively, yet very similar among patients that developed AKI with vs. without DM (30-day MACE 40.8% vs. 40.3%, <i>p</i> = 0.9 1-year mortality 43.7 vs. 44.8%, <i>p</i> = 0.8, respectively). Multivariate analyses adjusted to potential confounders, showed similar independent predictors of AKI among patients with and without DM, comprising; older age, chronic kidney disease, congestive heart failure, and peripheral arterial disease. Conclusions: Although patients with DM are at much greater risk for AKI when admitted with ACS, the independent predictors of AKI and the worse patient outcomes when AKI occurs, are similar irrespective to DM status.
format	article
author	Arthur Shiyovich Keren Skalsky Tali Steinmetz Tal Ovdat Alon Eisen Abed Samara Roy Beigel Sagi Gleitman Ran Kornowski Katia Orvin
author_facet	Arthur Shiyovich Keren Skalsky Tali Steinmetz Tal Ovdat Alon Eisen Abed Samara Roy Beigel Sagi Gleitman Ran Kornowski Katia Orvin
author_sort	Arthur Shiyovich
title	Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus
title_short	Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus
title_full	Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus
title_fullStr	Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus
title_full_unstemmed	Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus
title_sort	acute kidney injury following admission with acute coronary syndrome: the role of diabetes mellitus
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/03219a25e8dc4b5f8acc32420a0746f1
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Acute Kidney Injury Following Admission with Acute Coronary Syndrome: The Role of Diabetes Mellitus

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