Complicaciones asociadas a la hiperglucemia en pacientes trasplantados de riñón

Julián Felipe Montoya-Escobar , Carlos Esteban Builes-Montaño , Carolina Aguilar-Londoño , Karen Palacios-Bayona , Gustavo Adolfo Zuluaga-Valencia , Johnayro Gutiérrez-Restrepo , Clara María Arango-Toro , Fabián Alberto Jaimes-Barragan
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引用次数: 1

Abstract

Introduction

Hyperglycemia has been considered as a negative factor in hospitalized patients, both diabetic and non-diabetic, and has been related to the presence of diverse adverse outcomes. In kidney transplant patients, surgical stress, immunosuppressive drugs and prolonged hospital stays may be factors that promote hyperglycemia. However, has not been studied whether hyperglycemia during transplantation is associated with increased risk of rejection.

Population and methods

A retrospective cohort study in patients older than 15 years who received a kidney transplant and that included measurements of glucose in the first 48 hours after transplantation. We evaluated the presence of hyperglycemia defined in three different ways (as a single value, as averaged value and as time-weighted value) in patients undergoing renal transplantation and its relationship to the risk of acute rejection and length of hospital stay.

Results

While a large number of patients (91%) had some form of hyperglycemia during the first 48 hours after transplantation regardless of how it was defined, there was no an increased risk of rejection (OR = 0.35; 95% CI = 0.11-1.08) or a difference in length of stay (13.2 vs. 8.9 days, P = .958).

Conclusions

It is common to find some form of hyperglycemia during the first 48 hours after kidney transplantation, but its presence does not entail increased risk of transplant rejection or longer hospital stay when compared with patients who did not present it.

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肾移植患者高血糖相关并发症
高血糖一直被认为是住院患者(无论是糖尿病患者还是非糖尿病患者)的一个负面因素,并且与多种不良结局的存在有关。在肾移植患者中,手术压力、免疫抑制药物和延长住院时间可能是促进高血糖的因素。然而,尚未研究移植期间高血糖是否与排斥风险增加有关。人群与方法一项对年龄大于15岁接受肾移植患者的回顾性队列研究,包括移植后48小时内的血糖测量。我们以三种不同的方式(单一值、平均值和时间加权值)评估了肾移植患者高血糖的存在及其与急性排斥反应风险和住院时间的关系。结果大量患者(91%)在移植后48小时内出现某种形式的高血糖,无论如何定义,排斥反应的风险没有增加(OR = 0.35;95% CI = 0.11-1.08)或住院时间差异(13.2天vs 8.9天,P = 0.958)。结论:肾移植术后48小时内出现某种形式的高血糖是很常见的,但与未出现高血糖的患者相比,出现高血糖并不会增加移植排斥反应的风险或延长住院时间。
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