To investigate the effects of perioperative glycemic variability on postoperative acute kidney injury after off-pump coronary artery bypass grafting
Acute kidney injury (AKI) was defined by Kidney Disease Improving Global Outcomes (KDIGO) criteria. Glycemic variability was measured by Maximal blood glucose difference (MGD). The MGD was analyzed as quartiles and all patients were divided into four groups. Group 1: MGD < 5.4 mmol/L, Group 2: MGD 5.4-7.1 mmol/L, Group 3: MGD 7.1-9.1 mmol/L, Group 4: MGD > 9.1 mmol/L.
1,426 patients underwent OPCABG were analyzed. Postoperative AKI developed in 338 patients (28.1%). The incidence of overall AKI in four groups was 22%, 22%, 29% and 40%, respectively. It was higher in group 3 to 4 than group 1 to 2 and higher in group 4 than group 3(P<0.05). The incidence of AKI stage II and III was higher in group 4 than Group1 to 3. The length of postoperative ICU intubation, stay and hospitalization was significantly longer in group 4 than those in the lower three MGD Groups.
Increased glycemic variability is significantly associated with the risk of postoperative AKI after OPCABG.
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