The impact of acute kidney injury in diabetes mellitus.

BACKGROUND: Little data exist on outcome of acute kidney injury (AKI) in diabetes. We describe short-term recovery of renal function, patient mortality and progressive renal dysfunction following AKI in diabetic patients. METHODS: Using the diagnosis of either diabetes or no diabetes as the defining variable, AKI episodes were identified from records of a clinical biochemistry department serving a population of 560 000. Patient co-morbidity and mortality were collated from electronic patient records. Outcomes were compared with a non-diabetic cohort with AKI. RESULTS: Acute kidney injury was identified in 101 diabetic and 392 non-diabetic patients. Patients with diabetes had less severe AKI, compared with the non-diabetic cohort (AKI stage 1 76% vs 55%, P = 0.0006). Overall acute mortality, and mortality adjusted for co-morbidity, was comparable in the diabetic and non-diabetic groups. Recovery to baseline renal function was greater in diabetic patients (87% vs 63% P = 0.001), and the proportion of patients developing progressive chronic kidney disease was lower in the (14%) compared with the non-diabetic cohort (48%, P < 0.00001). CONCLUSIONS: Although acute mortality is comparable following an AKI episode in diabetic patients compared with that associated with AKI in a non-diabetic cohort, for those surviving the acute episode, its impact on renal function is significantly less than in a non-diabetic group.