The prognostic impact of the Stress Hyperglycemia Ratio on End‐Stage Renal Disease among patients with Diabetic Kidney Disease
Authors' conclusion
This study observed a U-shaped relationship between SHR and ESRD in patients with DKD. Both very high and very low SHR values correlate with increased risks, highlighting the critical importance of glucose management in chronic diabetes care.
Study context
- Population
- Patients with Diabetic Kidney Disease (DKD): Cohort 1 from the West China Hospital T2DM-DKD cohort (January 2008-September 2020); Cohort 2 retrospective cohort from Sichuan University Hospital (January 2019-May 2022)Cohort 1
- Participants
- 316 patients
- Exposure
- Stress Hyperglycemia Ratio (SHR) tertiles: SHR <0.7 and SHR ≥0.94 vs SHR ≥0.7 to <0.94
- Outcome
- ESRD
- Follow-up
- Median 42 months (Cohort 1)
Methodological detailstwo cohorts, Cox proportional hazards models adjusted for key confounders
- Two cohorts
- Cox proportional hazards models adjusted for key confounders
Main finding
As reported in the abstract
ESRD (Cohort 1) · median follow-up 42 months
Each group vs T2Hazard ratio (95% CI)
T1
1.71(1.01–2.90)
T3
1.93(1.16–3.20)
- Developed End-Stage Renal Disease (ESRD), overall
- 38.6%
- Kaplan-Meier: higher ESRD incidence in lowest and highest tertiles vs middle
- P < 0.01
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted HR (95% CI) | |
|---|---|---|
| ≥30% eGFR decline or ESRD (Cohort 2) · median follow-up 18.6 monthsT1vs T2SHR <0.7 | 2.18 (1.15–4.11) | |
| ≥30% eGFR decline or ESRD (Cohort 2) · median follow-up 18.6 monthsT3vs T2SHR ≥0.94 | 2.68 (1.38–5.23) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Original publication
The prognostic impact of the Stress Hyperglycemia Ratio on End‐Stage Renal Disease among patients with Diabetic Kidney Disease. Diabetes Obes Metab. Published 21 November 2024. doi:10.
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