ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-OR014

Impact of Intensive Glycemic Control in the Development of AKI after Cardiac Surgery: A Randomized Clinical Trial

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Santana-Santos, Eduesley, Federal University of Sergipe, Aracaju, Sergipe, Brazil
  • Vattimo, Maria De Fatima, School of Nursing University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil
  • da Fonseca, Cassiane Dezoti, Federal University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil
  • Bastos, Kleyton Andrade, Federal University of Sergipe, Aracaju - Sergipe, Brazil
  • Menezes, Andreia Freire de, Federal University of Sergipe, Aracaju - Sergipe, Brazil

Group or Team Name

  • Grupo Interdisciplinar de Estudos em Cuidados Críticos - GIEsCC
Background

Hyperglycemia is directly linked to higher rates of morbidity and mortality in hospitalized patients and is recognized as an important risk factor for postoperative complications. We performed a randomized controlled trial to evaluate the impact of an intensive glycemic control strategy in the occurrence of acute kidney injury in patients undergoing cardiac surgery.

Methods

Were included patients who presented blood glucose greater than 200 mg/dl in the first 6 hours of admission to the ICU. Patients aged less than 18 yo, diagnosed with congenital heart disease and heart transplantation were excluded. The patients were allocated in one of the groups: conventional group (CG), glucose target between 140 and 180 mg/dl and the intensive group (IG), glucose target between 90 and 110 mg/dl. The primary endpoint was AKI defined according with KDIGO criteria. The secondary outcomes were mortality, need for dialysis, renal function recovery, hypoglycemia, ICU discharge, length of stay in ICU.

Results

Were included 95 patients, 36 (37.9%) in the IG and 59 (62.1%) in the CG. In the comparison between groups, no significant difference was observed in relation to the surgical risk (p = 0.511) and the risk for acute kidney injury (p = 0.962), measured by the EuroSCORE and Cleveland Clinic Score, respectively. Using vasoactive drugs was higher in the IG as compared to CG (97.2% vs. 83.1%; p = 0.047). There was no difference in the incidence of AKI in IG, when compared with CG (61.1% vs. 49.2%; p = 0.294, respectively). Nevertheless, the return of kidney function to the basal values was smaller in the IG as compared to CG (41.7% vs. 69.5%; p = 0.010, respectively). There was no found any difference between the groups in relation to mortality (p = 0.066), need for dialysis (p = 0.364) and episodes of hypoglycemia (p = 0.151). There was a higher number of ICU discharges in the CG, when compared with IG (98.3% vs. 86.1%; p = 0.028, respectively) as well as shorter length of stay in the ICU (4.2 + 3.0 vs. 5.7 + 4.2; p = 0.046, respectively).

Conclusion

The intensive glycemic control strategy used in this study was not associated with decrease in the incidence of acute kidney injury in patients undergoing cardiac surgery also influenced negatively in secondary outcomes.