Trial reportJournal of the American Society of Nephrology : JASN2008
Tight blood glucose control is renoprotective in critically ill patients.
Trial report in Journal of the American Society of Nephrology : JASN, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 3 syntheses or guidelines pooled it, 144 citations in OpenAlex.
- Perioperative Clinical Trials in AKI.Seminars in nephrology · 2020Pooled it
- Prevention of acute kidney injury and protection of renal function in the intensive care unit: update 2017 : Expert opinion of the Working Group on Prevention, AKI section, European Society of Intensive Care Medicine.Intensive care medicine · 2017Pooled it
- Prevention of acute kidney injury and protection of renal function in the intensive care unit. Expert opinion of the Working Group for Nephrology, ESICM.Intensive care medicine · 2010Guideline
- Prevention of cardiac surgery-associated AKI by implementing the KDIGO guidelines in high risk patients identified by biomarkers: the PrevAKI randomized controlled trial.Intensive care medicine · 2017Trial
- Stress hyperglycemia ratio predicts outcome in stroke patients without diabetes and builds a nomogram: a multi-center retrospective cohort study in a Chinese population.European journal of medical research · 2026Article
- The kidney: the critical organ system for guiding nutrition therapy in the ICU-patient?Critical care (London, England) · 2024Article
- Kidney Dysfunction After Traumatic Brain Injury: Pathophysiology and General Management.Neurocritical care · 2023Review
- Energy metabolic reprogramming regulates programmed cell death of renal tubular epithelial cells and might serve as a new therapeutic target for acute kidney injury.Frontiers in cell and developmental biology · 2023Review
- Construction of a Glycaemia-Based Signature for Predicting Acute Kidney Injury in Ischaemic Stroke Patients after Endovascular Treatment.Journal of clinical medicine · 2022Article
- Review
- Stress Hyperglycemia, Diabetes Mellitus and COVID-19 Infection: Risk Factors, Clinical Outcomes and Post-Discharge Implications.Frontiers in clinical diabetes and healthcare · 2022Review
- Peptide VSAK maintains tissue glucose uptake and attenuates pro-inflammatory responses caused by LPS in an experimental model of the systemic inflammatory response syndrome: a PET study.Scientific reports · 2021Article
- Outcome of acute kidney injury: how to make a difference?Annals of intensive care · 2021Review
- Glucose Metabolism in Acute Kidney Injury and Kidney Repair.Frontiers in medicine · 2021Review
- Article
- Acute Hyperglycemia May Induce Renal Tubular Injury Through Mitophagy Inhibition.Frontiers in endocrinology · 2020Article
- Intraoperative glucose variability, but not average glucose concentration, may be a risk factor for acute kidney injury after cardiac surgery: a retrospective study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2019Article
- [Metabolic management and nutrition in critically ill patients with renal dysfunction : Recommendations from the renal section of the DGIIN, ÖGIAIN, and DIVI].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2018Article
- [Prevention of acute kidney injury in critically ill patients : Recommendations from the renal section of the DGIIN, ÖGIAIN and DIVI].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2018Review
- Compatibility of Nitric Oxide Release with Implantable Enzymatic Glucose Sensors Based on Osmium (III/II) Mediated Electrochemistry.ACS sensors · 2017Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Two large, prospective, randomized, controlled trials have shown a beneficial effect of intensive insulin therapy (IIT) on the kidney function of critically ill patients. The data from these trials were combined for performance of a more detailed analysis of the renoprotective effect of IIT. After exclusion of 41 patients with preadmission ESRD, the study sample comprised 2707 critically ill patients who were randomly assigned to conventional or IIT. A modified risk-injury-failure-loss-ESRD (mRIFLE) system was used to classify acute kidney injury such that mRIFLE-Injury and -Failure (mR-IF) corresponded to peak serum creatinine levels >/=2x and >/=3x the admission levels, respectively. IIT significantly reduced the incidence of mR-I or -F from 7.6 to 4.5% (P = 0.0006), and this renoprotective effect was most pronounced in patients who achieved strict normoglycemia. In surgical patients, IIT also significantly reduced oliguria (from 5.6 to 2.6%; P = 0.004) and the need for renal replacement therapy (from 7.4 to 4.0%; P = 0.008). In medical patients, the incidence of mR-I or -F decreased to a lesser extent, perhaps because a greater severity of illness at admission may have rendered preventive therapies less effective. In conclusion, this secondary analysis of two large, randomized, controlled trials suggests that IIT, with a goal of achieving normoglycemia, protects the renal function of critically ill patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.