Acute Kidney Injury Increases Risk for Postdischarge Hypoglycemia in Diabetes
Hypoglycemia incidence was highest for insulin users, followed by glyburide and glipizide users.
HealthDay News — For hospitalized patients with diabetes, acute kidney injury (AKI) is a risk factor for post-discharge hypoglycemia, according to a study published online in Diabetes Care.
Adriana M. Hung, MD, from Veterans Affairs Tennessee Valley in Nashville, and colleagues performed a propensity-matched analysis of patients with diabetes, with and without AKI, using a retrospective cohort of veterans hospitalized between 2004 and 2012. The authors compared the risk for hypoglycemia within 90 days post-discharge among hospitalized patients with diabetes with and without AKI.
The researchers identified 65,151 propensity score-matched pairs with and without AKI. Per 100 person-years, the incidence of hypoglycemia was 29.6 and 23.5, respectively, for patients with and without AKI. AKI correlated with an increased risk of hypoglycemia after adjustment (hazard ratio, 1.27).
The hazard ratios were 1.18, 1.30, and 1.48 for patients with full recovery, partial recovery, and no recovery, respectively, compared to patients without AKI. Patients with vs those without AKI experienced hypoglycemia more frequently across all anti-diabetes drug regimens; hypoglycemia incidence was highest for insulin users, followed by glyburide and glipizide users.
"AKI is a risk factor for hypoglycemia in the post-discharge period," the authors write. "Studies to identify risk-reduction strategies in this population are warranted."
Hung AM, Siew Ed, Wilson OD, et al. Risk of hypoglycemia after hospital discharge after acute kidney injury in patients with diabetes [published online January 11, 2018]. Diabetes Care. doi: 10.2337/dc17-1237