The association between stress-induced hyperglycemia ratio and cardiovascular events as well as all-cause mortality in patients with chronic kidney disease and diabetic nephropathy
Authors' conclusion
This study highlights a significant association between the stress hyperglycemia ratio (SHR) and both all-cause and cardiovascular mortality in patients with diabetic kidney disease (DKD) or chronic kidney disease (CKD).
Study context
- Population
- Individuals with DKD or chronic kidney disease (CKD), National Health and Nutrition Examination Survey (NHANES) 1999–2018; mean age 60.7 years, 56% female
- Participants
- 3,507 individuals
- Exposure
- Stress hyperglycemia ratio (SHR) quartiles
- Outcome
- All-cause mortality and cardiovascular mortality (National Death Index)
- Follow-up
- Through December 31, 2019
Methodological detailsNHANES 1999–2018, SHR quartiles, Cox proportional hazards regression
- NHANES 1999–2018
- SHR quartiles
- Cox proportional hazards regression
Main finding
As reported in the abstract
All-cause mortality
Hazard ratio (95% CI)
Q2
0.76(0.63–0.92)
Q4
1.26(1.04–1.52)
- Q2 had the lowest all-cause mortality (Kaplan-Meier)
- log-rank P = 0.003
- Overall all-cause mortality incidence
- 38,000 per 100,000 person-years
- SHR value of minimum risk, all-cause mortality
- 0.923
Observational data: associations, not effects.
Further findings
Cardiovascular mortality
- Overall CV mortality incidence
- 11,405 per 100,000 person-years
- SHR value of minimum risk, CV mortality
- 1.026
- U-shaped association between SHR and CV mortality (restricted cubic spline (RCS))
Subgroup analyses
- Effect consistent across all subgroups
Original publication
The association between stress-induced hyperglycemia ratio and cardiovascular events as well as all-cause mortality in patients with chronic kidney disease and diabetic nephropathy. Cardiovasc Diabetol. Published 6 February 2025. doi:10.
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