ArticlePloS one2026
Impact of the stress hyperglycemia ratio on short-term outcomes in critically ill patients with chronic kidney disease: A comparative analysis of diabetic and non-diabetic populations.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStress-induced hyperglycemia is common in critically ill patients and may worsen outcomes, especially in those with chronic kidney disease (CKD). The stress hyperglycemia ratio (SHR), defined as admission glucose divided by the estimated average glucose from HbA1c, reflects acute relative hyperglycemia, but its prognostic value in CKD remains unclear.
objectiveTo investigate the impact of SHR on ICU and 28-day mortality in critically ill CKD patients and to compare prognostic differences between diabetic and non-diabetic populations.
methodsData of 1,836 CKD patients from the MIMIC-IV database were analyzed. SHR was categorized into quartiles, and patients were stratified by diabetes status. Kaplan-Meier survival analysis assessed ICU and 28-day mortality; Cox proportional hazards and restricted cubic spline (RCS) analyzes evaluated associations between SHR and outcomes. Subgroup analyzes explored effect modification by age, sex, and comorbidities.
resultsIn non-diabetic patients, higher SHR levels were independently associated with increased ICU and 28-day mortality. The adjusted hazard ratios (HRs) for ICU and 28-day mortality in the highest SHR quartile were 3.19 (95% CI: 1.60-6.53, P < 0.001) and 1.93 (95% CI: 1.14-3.27, P = 0.015), respectively. In diabetic patients, similar upward trends were observed, but the associations were not statistically significant after multivariate adjustment.
conclusionsElevated SHR levels were associated with adverse short-term outcomes, particularly increased ICU and 28-day mortality in non-diabetic patients with chronic kidney disease. These findings suggest that stress-induced hyperglycemia may exert a harmful effect on critically ill patients without preexisting diabetes, emphasizing the importance of individualized glycemic management in this population.
Indexed as
Identifiers
What OpenQuestion holds
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.