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
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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