Mr Jie Mao1
1Chongoing University Fuling Hospital, Chongqing, China
Biography:
A nephrologist specializing in renal medicine, he graduated from Chongqing Medical University. With extensive experience in basic and clinical research on kidney diseases and hemodialysis, he is particularly skilled in diagnosing and managing critical acute kidney injury (AKI), and proficient in applying various blood purification techniques including continuous renal replacement therapy (CRRT) for multi-organ failure. He also possesses extensive clinical expertise in diagnosing and treating primary and secondary glomerular diseases (such as IgA nephropathy, membranous nephropathy, diabetic nephropathy, and hypertensive kidney
Abstract:
Background: The stress hyperglycemia ratio (SHR) is a novel biomarker of relative hyperglycemia during acute illness and has been demonstrated to be prognostic in various critical conditions. However, its specific association with outcomes in patients with acute kidney injury (AKI) remains less clear. This study aimed to investigate the association of SHR with 90-day all-cause mortality, as well as progression to chronic kidney disease (CKD), among AKI patients.
Methods: We conducted a retrospective cohort study of 176 patients (mean age 57 years, 68.8% men) diagnosed with AKI at the Department of Nephrology, *** Hospital between October 2022 and December 2024. The primary exposure, SHR, was calculated from admission blood glucose and glycated hemoglobin A1c levels. The primary outcome was 90-day mortality, and the secondary outcome was transition to CKD. Multivariable logistic regression models were used to assess the relationship between SHR and 90-day mortality risk and CKD transition risk.
Results: Within 90 days, 39 patients (22.2%) died, and among the 127 survivors, 43 (33.9%) developed CKD. Multivariate-adjusted logistic regression analysis showed the odds ratios (95% confidence intervals) were 1.79 (1.56-2.01) for 90-day mortality and 2.42 (2.04-2.71) for CKD transition. Receiver-operating characteristic curves demonstrated that the SHR discriminated 90-day mortality and CKD transition with area under the curves of 0.71 and 0.76, respectively.
Conclusion: SHR is an independent prognostic indicator for both 90-day mortality and CKD transition in patients with AKI, highlighting its potential utility for risk stratification and patient management.