Objective: To evaluate the impact of intensive glycemic control on the reduction of the incidence of acute renal injury in adult patients undergoing cardiac surgery. Methods: Randomized clinical trial, evaluating 95 patients undergoing two glycemic control strategies. Patients were randomized to the intervention n group (IG), with the goal of maintaining postoperative glycemia between 90 and 110 mg/dl. For patients allocated into the conventional group (CG) the goal was to maintain glycaemia between 140 and 180 mg/dl. The insulin dose adjustment was based on undiluted arterial blood glucose measurements at one hour intervals, by means of a blood glucose and beta-ketone monitoring system. Results: The incidence of acute kidney injury was 53.7% (KDIGO stages 1, 2 or 3). There was no significant difference between the groups regarding the primary outcome (p=0.294). However, a greater frequency of complete renal function recovery (p = 0.010), ICU discharge (p = 0.028), and hospital discharge (p = 0.048) was found among patients undergoing conventional glycemic control. The use of intensive glycemic control was associated with longer ICU stay (p=0.031). The number of episodes of hypoglycemia was similar in both groups (1.6±0.9 vs. 1.3±0.6, p=0.731), demonstrating the safety of the strategies used. Conclusion: The impact of intensive glycemic control on reducing the incidence of acute kidney injury was not observed. In contrast, patients treated in the CG had a higher frequency of complete renal function recovery.
CITATION STYLE
Santana-Santos, E., Kanke, P. H., de Cássia Almeida Vieira, R., de Oliveira, L. B., de Lucena Ferretti-Rebustini, R. E., de Menezes, A. F., … Hajjar, L. A. (2019). Impact of intensive glycemic control on acute renal injury: A randomized clinical trial. ACTA Paulista de Enfermagem, 32(6), 592–599. https://doi.org/10.1590/1982-0194201900083
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