Changes in Serum Creatinine May Cause Hypoglycemia among Non-Critically Ill Patients Admitted to Internal Medicine Units

Boris Zingerman, Israel Khanimov, Mordechai Shimonov, Mona Boaz, Benaya Rozen-Zvi, Eyal Leibovitz*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The association between changes in serum creatinine levels and hypoglycemia during hospitalization was investigated. Methods: This was a retrospective analysis of medical charts. Patients were categorized as having significant change in creatinine (SCIC) when serum creatinine levels rose or dropped ≥ 0.3 mg/dL from admission values at any time during their hospitalization. Patients were considered hypoglycemic if they had at least one documented glucose level ≤ 70 mg/dL during the hospitalization. Multiple logistic, linear and Cox regression analyses were used to ascertain the association between incident SCIC, severity and timing with incident hypoglycemia. Results: Included were 25,400 (mean age 69.9 ± 18.0, 49.3% were males). The rate of SCIC was 22.2%, and 62.2% of them were diagnosed upon admission. Patients with SCIC had a higher incidence of hypoglycemia compared to patients without (13.1% vs. 4.1%, respectively, p < 0.001). Patients with SCIC had an increased risk of hypoglycemia (OR 1.853, 95% CI 1.586–2.166, p < 0.001). The magnitude of SCIC was associated with the incidence (OR 1.316, 95% CI 1.197–1.447, p < 0.001) and the number of events (HR 0.054, 95% CI 0.021–0.087, p = 0.001). More than 60% of patients with hypoglycemia had their first event documented during days 0–6 after SCIC occurrence. Of those, the majority of events occurred on day 0–1, and the rate showed a gradual decrease throughout the first 5 days from SCIC occurrence. The results were similar for patients with and without DM. Conclusions: Changes in creatinine during hospitalization may cause hypoglycemia among patients admitted to internal medicine departments, regardless of DM status.

Original languageEnglish
Article number6852
JournalJournal of Clinical Medicine
Volume11
Issue number22
DOIs
StatePublished - Nov 2022

Keywords

  • acute kidney injury
  • creatinine
  • diabetes mellitus
  • hypoglycemia

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