Endocrine · 2026
Diabetic ketoacidosis in end-stage renal disease: propensity score-matched national inpatient outcomes.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Anwaar Nida, Quazi Mohammed A, Baron Herrera David A, Saeed Humza, Ravender Raja, Mando-Dakkak Eyad, Sheikh Abu Baker
Аннотация
BACKGROUND: Diabetic ketoacidosis (DKA) increasingly occurs in patients with end-stage renal disease (ESRD), in whom standard management strategies may not be appropriate. Prior studies evaluating outcomes of DKA in ESRD are limited and yield inconsistent results. We compared in-hospital outcomes and healthcare utilization among patients hospitalized with DKA with and without ESRD using a national database.
METHODS: We performed a retrospective cohort study using the National Inpatient Sample (2016-2022) of adult hospitalizations with a primary diagnosis of DKA, comparing patients with and without ESRD. Propensity score matching was used to balance demographics and comorbidities; multivariable regression was used to estimate adjusted odds ratios (aORs) for in-hospital mortality, major in-hospital complications, length of stay, and inflation-adjusted hospitalization costs.
RESULTS: After propensity score matching, 78,470 hospitalizations were included (39,235 with ESRD and 39,235 without ESRD). In-hospital mortality was similar between patients with and without ESRD (0.9% vs. 1.0%; aOR 0.90, 95% CI 0.65-1.24; p = 0.524). However, ESRD was associated with significantly higher odds of vasopressor use (aOR 1.56), invasive mechanical ventilation (aOR 1.74), non-invasive ventilation (aOR 1.62), septic shock (aOR 1.71), seizures (aOR 1.67), and sudden cardiac arrest (aOR 1.65) (all p < 0.05). ESRD was also associated with longer hospital length of stay (+ 1.42 days) and higher inflation-adjusted hospitalization costs (+$24,686) compared with matched non-ESRD patients.
CONCLUSIONS: Among patients hospitalized with DKA, ESRD was not associated with increased in-hospital mortality after adjustment but was linked to substantially greater morbidity and healthcare resource utilization. These findings highlight the need for ESRD-adapted DKA management strategies aimed at reducing complications rather than mortality alone.
METHODS: We performed a retrospective cohort study using the National Inpatient Sample (2016-2022) of adult hospitalizations with a primary diagnosis of DKA, comparing patients with and without ESRD. Propensity score matching was used to balance demographics and comorbidities; multivariable regression was used to estimate adjusted odds ratios (aORs) for in-hospital mortality, major in-hospital complications, length of stay, and inflation-adjusted hospitalization costs.
RESULTS: After propensity score matching, 78,470 hospitalizations were included (39,235 with ESRD and 39,235 without ESRD). In-hospital mortality was similar between patients with and without ESRD (0.9% vs. 1.0%; aOR 0.90, 95% CI 0.65-1.24; p = 0.524). However, ESRD was associated with significantly higher odds of vasopressor use (aOR 1.56), invasive mechanical ventilation (aOR 1.74), non-invasive ventilation (aOR 1.62), septic shock (aOR 1.71), seizures (aOR 1.67), and sudden cardiac arrest (aOR 1.65) (all p < 0.05). ESRD was also associated with longer hospital length of stay (+ 1.42 days) and higher inflation-adjusted hospitalization costs (+$24,686) compared with matched non-ESRD patients.
CONCLUSIONS: Among patients hospitalized with DKA, ESRD was not associated with increased in-hospital mortality after adjustment but was linked to substantially greater morbidity and healthcare resource utilization. These findings highlight the need for ESRD-adapted DKA management strategies aimed at reducing complications rather than mortality alone.