Admission Hyperglycemia Is an Independent Predictor of Acute Kidney Injury in Patients With Acute Myocardial Infarction

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  • Moriyama Noriaki
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Ishihara Masaharu
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Noguchi Teruo
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Nakanishi Michio
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Arakawa Tetsuo
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Asaumi Yasuhide
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Kumasaka Leon
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Kanaya Tomoaki
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Miyagi Tadayoshi
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Nagai Toshiyuki
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Yamane Takafumi
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Fujino Masashi
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Honda Satoshi
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Fujiwara Reiko
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Anzai Toshihisa
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Kusano Kengo
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Goto Yoichi
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Yasuda Satoshi
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Ogawa Hisao
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

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Abstract

Background: Acute kidney injury (AKI) and acute hyperglycemia are associated with unfavorable outcomes. The impact of acute hyperglycemia on the development of AKI after acute myocardial infarction (AMI), however, remains unclear. This study was undertaken to assess the relationship between admission glucose and incidence of AKI after AMI. Methods and Results: This study consisted of 760 patients with AMI admitted to the National Cerebral and Cardiovascular Center within 48h after symptom onset. Blood sample was obtained on admission and repeated sampling was done at least every 1 or 2 days during the first week. AKI was diagnosed as increase in serum creatinine ≥0.3mg/dl or ≥50% within any 48h. Ninety-six patients (13%) had AKI during hospitalization for AMI, and these patients had higher in-hospital mortality than those without AKI (25% vs. 3%, P<0.001). Patients with AKI had higher plasma glucose (PG) on admission than those without (222±105mg/dl vs. 166±69mg/dl, P<0.001). The incidence of AKI increased as admission PG rose: 7% with PG <120mg/dl; 9% with PG 120–160mg/dl; 11% with PG 160–200mg/dl; and 28% with PG >200mg/dl (P<0.01). On multivariate analysis admission PG was an independent predictor of AKI (odds ratio, 1.10; 95% confidence interval: 1.03–1.18, P=0.02). Conclusions: Admission hyperglycemia might have contributed to the development of AKI in patients with AMI.  (Circ J 2014; 78: 1475–1480)<br>

Journal

  • Circulation Journal

    Circulation Journal 78 (6), 1475-1480, 2014

    The Japanese Circulation Society

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