Abstract

Background: Acute kidney injury (AKI) frequently complicates acute heart failure (AHF), predicting worse outcomes. Early risk identification is crucial. The stress hyperglycemia ratio (SHR), reflecting acute dysglycemia, may predict AKI, but its utility in AHF remains unestablished.
Materials and methods: We analyzed 1,241 AHF patients stratified by SHR. Associations with outcomes were assessed using logistic and Cox regression. The relationship between continuous SHR and AKI development was evaluated with restricted cubic splines (RCS). The primary endpoint was incident AKI during hospitalization.
Results: AKI occurred in 79.7% of patients. After multivariable adjustment, SHR demonstrated a linear association with AKI risk. For 28-day mortality, the relationship with SHR was U-shaped, with an inflection point at 0.841. An SHR > 0.841 was associated with significantly increased mortality (OR = 2.086; 95% CI: 1.368 – 3.182). An elevated SHR was consistently associated with higher AKI risk across all patient subgroups, with an overall adjusted OR of 1.60 (95% CI: 1.15 – 2.22).
Conclusion: The study demonstrates a linear association between the SHR and AKI, in contrast to a U-shaped relationship with 28-day in-hospital mortality among AHF patients. An SHR of 0.841 represents a critical threshold for evaluating in-hospital mortality risk.

Author Details

Authors

• Keran Xie¹
• Siqi Gao¹
• Xinran Liu³
• Aibin Cheng²
• Runhao Liang³
• Jianjun Wang²
• Jianmin Li²
• Junjie Liu¹,²

Departments

• ¹ College of Clinical Medicine, North China University of Science and Technology,
• ² Department of Critical Care Medicine, the Affiliated Hospital of North China University of Science and Technology, and
• ³ School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, China

Address

Junjie Liu, MD
Department of Critical Care Medicine
College of Clinical Medicine
North China University of Science and Technology
Tangshan, 063099, China
Email: [email protected]

Citation