Clinical characteristics and outcomes of patients with end-stage renal disease hospitalized with diabetes ketoacidosis
Autor: | Rodolfo J. Galindo, Katerina Tsegka, Guillermo E. Umpierrez, Heqiong Wang, Maya Fayfman, Saumeth Cardona, Priyathama Vellanki, Neil Dhruv, Francisco J. Pasquel |
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Rok vydání: | 2020 |
Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Adolescent Diabetic ketoacidosis Endocrinology Diabetes and Metabolism medicine.medical_treatment Renal function 030209 endocrinology & metabolism Hypoglycemia Clinical Care/Education/Nutrition Diseases of the endocrine glands. Clinical endocrinology Diabetic Ketoacidosis End stage renal disease Hospitals University Young Adult 03 medical and health sciences 0302 clinical medicine ketoacidosis Renal Dialysis Diabetes mellitus Internal medicine Humans Medicine Hospital Mortality 030212 general & internal medicine ESRD Dialysis Aged Retrospective Studies Aged 80 and over Glycated Hemoglobin business.industry Length of Stay Middle Aged RC648-665 medicine.disease Respiration Artificial 3. Good health Ketoacidosis dialysis Kidney Failure Chronic Female Hemodialysis business |
Zdroj: | BMJ Open Diabetes Research & Care, Vol 8, Iss 1 (2020) BMJ Open Diabetes Research & Care |
ISSN: | 2052-4897 |
Popis: | IntroductionThere is limited evidence to guide management in patients with end-stage renal disease (ESRD) on chronic hemodialysis admitted with diabetes ketoacidosis. Thus, we investigated the clinical characteristics and outcomes of patients with ESRD admitted with diabetic ketoacidosis (DKA).MethodsIn this observational study, we used International Classification of Diseases Ninth/Tenth Revision codes to identify adult (aged 18–80 years) patients admitted to Emory University Hospitals between 1 January 2006 and 31 December 2016. DKA and ESRD diagnoses were confirmed by reviewing medical records and by admission laboratory results.ResultsAmong 307 patients with DKA meeting the inclusion and exclusion criteria, 22.1% (n: 68) had ESRD on hemodialysis and 77.9% (n: 239) had preserved renal function (estimated glomerular filtration rate >60 mL/min/1.73 m2). Compared with patients with preserved renal function, the admission blood glucose was higher (804.5±362.6 mg/dL vs 472.5±137.7 mg/dL) and the mean hemoglobin A1c was lower (9.6%±2.1 vs 12.0%±2.5) in patients with DKA and ESRD, both pConclusionsPatients with DKA and ESRD on chronic hemodialysis had worse clinical outcomes including higher rates of hypoglycemia, volume overload, need for mechanical ventilation and longer length of stay, compared with patients with preserved kidney function. |
Databáze: | OpenAIRE |
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