A Comparative Analysis of Acute Kidney Injury Severity and Associated Factors in Diabetic and Non-Diabetic Patients Following Myocardial Infarction
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Abstract
Background: Acute kidney injury is an important complication of myocardial infarction, but comparative evidence describing renal, glycaemic, and cardiac differences between diabetic and non-diabetic patients with established post-MI AKI remains limited. Objective: To compare AKI severity and associated renal, glycaemic, and cardiac parameters between diabetic and non-diabetic patients following myocardial infarction. Methods: This comparative cross-sectional study included 248 post-MI patients with AKI recruited from the Punjab Institute of Cardiology and Mayo Hospital, Lahore, comprising 124 diabetic and 124 non-diabetic participants. AKI was classified using KDIGO serum creatinine criteria. Categorical variables were compared using Chi-square tests, and non-normally distributed continuous variables were analysed using the Mann–Whitney U test. Results: Overall, 50.0% had Stage 2 and 30.6% had Stage 3 AKI. Diabetes status was strongly associated with random blood glucose category (χ²(2) = 91.681, p < 0.001; Cramér’s V = 0.608), HbA1c category (χ²(2) = 153.249, p < 0.001; Cramér’s V = 0.786), and absolute serum creatinine category (χ²(2) = 25.451, p < 0.001; Cramér’s V = 0.320). Significant continuous-variable differences were observed for eGFR (p = 0.015), initial troponin (p = 0.033), and random blood glucose (p < 0.001), whereas serum creatinine, urea, blood urea nitrogen, and LVEF were not significantly different. Conclusion: Diabetic and non-diabetic post-MI patients with AKI demonstrated distinct renal, glycaemic, and cardiac profiles. Comprehensive assessment is warranted irrespective of documented diabetes status
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