Hyperglycemia and Acute Kidney Injury During the Perioperative Period

Current Diabetes Reports
Carlos E MendezBarbara Slawski

Abstract

Hyperglycemia and acute kidney injury (AKI) are frequently observed during the perioperative period. Substantial evidence indicates that hyperglycemia increases the prevalence of AKI as a surgical complication. Patients who develop hyperglycemia and AKI during the perioperative period are at significantly elevated risk for poor outcomes such as major adverse cardiac events and all-cause mortality. Early observational and interventional trials demonstrated that the use of intensive insulin therapy to achieve strict glycemic control resulted in remarkable reductions of AKI in surgical populations. However, more recent interventional trials and meta-analyses have produced contradictory evidence questioning the renal benefits of strict glycemic control. Although the exact mechanisms through which hyperglycemia increases the risk of AKI have not been elucidated, multiple pathophysiologic pathways have been proposed. Hypoglycemia and glycemic variability may also play a significant role in the development of AKI. In this literature review, the complex relationship between hyperglycemia and AKI as well as its impact on clinical outcomes during the perioperative period is explored.

References

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Citations

Mar 23, 2017·Journal of Nursing Care Quality·Sally O Gerard, Josephine Ritchie
Feb 23, 2019·Journal of Hepato-biliary-pancreatic Sciences·Minjae KimGuohua Li
Jul 27, 2017·BioMed Research International·Sasa NieXiangmei Chen
Aug 14, 2020·Journal of Diabetes Science and Technology·Guillermo UmpierrezDavid C Klonoff
Jan 13, 2018·Molecular Medicine Reports·Zhi-Rong ChenQun-Hua Jin
Jan 10, 2018·Anaesthesia·J McKinlayL G Forni
Nov 18, 2020·International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group·Chao-Yu ChenTing-Yao Wang
Nov 14, 2020·Anesthesia and Analgesia·Luca MolinariJohn A Kellum
Apr 23, 2021·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Carlos E MendezLeonard E Egede

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