Journal
JOURNAL OF DIABETES AND ITS COMPLICATIONS
Volume 27, Issue 1, Pages 41-43Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jdiacomp.2012.08.005
Keywords
Urinary tract infection; Diabetes; Chronic kidney disease; Acute kidney injury
Categories
Ask authors/readers for more resources
Objective: Urinary tract infection (UTI) exists in 9%-20% of female and 3%-11% of male patients with diabetes. Diabetic patients experience increased risk of bacteremia, hospitalization, and mortality; however, few studies report long-term renal outcomes of episodic UTI in diabetic patients with chronic kidney disease (CKD). Research Design and Methods: We investigated 225 diabetic patients admitted with UTI from 2001 to 2011. Based on the glomerular filtration rate (GFR) on admission, we divided the patients into early- (GFR >= 30 ml/min; n = 131) and late-stage (stages 4 and 5, GFR <30 ml/min; n = 94) CKD groups. We compared admission risk factors, post-UT! GFR decline and its long term trend between these groups. Results: Poor glycemic control contributed to admission with UTI in the early- and late-stage CKD patients (glycosylated hemoglobin: (9.7 +/- 2.8% versus 8.6 +/- 2.6%). Early-stage CKD patients exhibited higher urinary glucose. Besides, acute kidney injury (AKI) occurred on admission in late-stage CMD patients (mean eGFR 14.2 ml/min). However, if the-infection was cured, almost all diabetic patients reverted to their GFR trends 6 months later. Conclusions: Late-stage CKD diabetic patients with UTI are at increased risk of superimposed AKI. Almost all patients gradually reverted to their GFR trend later after infection was cured. Early recognition of complicating AKI factors and aggressive treatment of symptomatic UTI instead of antibiotic prophylaxis for asymptomatic bacteriuria are suggested. (C) 2013 Elsevier Inc. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available