Association between serum anion gap and all-cause mortality in critically ill patients with diabetic kidney disease: Analysis of the MIMIC-IV database.
<h4>Background</h4>Diabetic kidney disease (DKD) is one of the most common diabetic complications and is closely related to metabolic acidosis. The serum anion gap (AG), an important index of acid-base balance, may reflect disturbed metabolism and be correlated with increased mortality r...
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Public Library of Science (PLoS)
2025-01-01
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| Online Access: | https://doi.org/10.1371/journal.pone.0329269 |
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| author | Yu-Nan Han Cheng-Yue Xiong Yong-Xiang Wang Jun-Li Yuan Lin Li Zui-Xuan Xiao |
| author_facet | Yu-Nan Han Cheng-Yue Xiong Yong-Xiang Wang Jun-Li Yuan Lin Li Zui-Xuan Xiao |
| author_sort | Yu-Nan Han |
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| description | <h4>Background</h4>Diabetic kidney disease (DKD) is one of the most common diabetic complications and is closely related to metabolic acidosis. The serum anion gap (AG), an important index of acid-base balance, may reflect disturbed metabolism and be correlated with increased mortality risk. However, the role of AG in all-cause mortality risk in individuals suffering from severe DKD is not yet clear.<h4>Methods</h4>In this study, patients identified with a diagnosis of severe DKD utilizing MIMIC-IV database were determined. They were subsequently divided into four quartiles based on their serum AG levels. The findings consisted of in-hospital deaths and ICU deaths. The relationship between serum AG levels of severe DKD patients and clinical outcomes was elucidated using Cox proportional hazards regression analysis and RCS analysis.<h4>Results</h4>In total, 1,716 patients (66.43% male) received treatment, with in-hospital and ICU mortality rates reaching 16.43% and 13.17%, respectively. Multivariate Cox regression analysis revealed that elevated serum AG levels were remarkably linked to all-cause mortalities. When adjusted for confounders, elevated serum AG levels correlated notably with in-hospital mortality [HR = 1.09(95%CI:1.07,1.11)P < 0.0001] and ICU mortality [HR = 1.10(95%CI:1.07,1.12)P < 0.0001]. RCS analysis showed that serum AG levels were positively correlated in a linear fashion with all-cause death risk.<h4>Conclusion</h4>Serum AG shows a significant positive correlation with all-cause mortalities in hospitals and ICU settings among patients with severe DKD. This suggests that serum AG could serve as a potential indication for recognizing DKD individuals with an increased overall risk of all-cause death. |
| format | Article |
| id | doaj-art-154decdd9c2345bab2a6ae68cd9e3b41 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-154decdd9c2345bab2a6ae68cd9e3b412025-08-20T04:02:13ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01208e032926910.1371/journal.pone.0329269Association between serum anion gap and all-cause mortality in critically ill patients with diabetic kidney disease: Analysis of the MIMIC-IV database.Yu-Nan HanCheng-Yue XiongYong-Xiang WangJun-Li YuanLin LiZui-Xuan Xiao<h4>Background</h4>Diabetic kidney disease (DKD) is one of the most common diabetic complications and is closely related to metabolic acidosis. The serum anion gap (AG), an important index of acid-base balance, may reflect disturbed metabolism and be correlated with increased mortality risk. However, the role of AG in all-cause mortality risk in individuals suffering from severe DKD is not yet clear.<h4>Methods</h4>In this study, patients identified with a diagnosis of severe DKD utilizing MIMIC-IV database were determined. They were subsequently divided into four quartiles based on their serum AG levels. The findings consisted of in-hospital deaths and ICU deaths. The relationship between serum AG levels of severe DKD patients and clinical outcomes was elucidated using Cox proportional hazards regression analysis and RCS analysis.<h4>Results</h4>In total, 1,716 patients (66.43% male) received treatment, with in-hospital and ICU mortality rates reaching 16.43% and 13.17%, respectively. Multivariate Cox regression analysis revealed that elevated serum AG levels were remarkably linked to all-cause mortalities. When adjusted for confounders, elevated serum AG levels correlated notably with in-hospital mortality [HR = 1.09(95%CI:1.07,1.11)P < 0.0001] and ICU mortality [HR = 1.10(95%CI:1.07,1.12)P < 0.0001]. RCS analysis showed that serum AG levels were positively correlated in a linear fashion with all-cause death risk.<h4>Conclusion</h4>Serum AG shows a significant positive correlation with all-cause mortalities in hospitals and ICU settings among patients with severe DKD. This suggests that serum AG could serve as a potential indication for recognizing DKD individuals with an increased overall risk of all-cause death.https://doi.org/10.1371/journal.pone.0329269 |
| spellingShingle | Yu-Nan Han Cheng-Yue Xiong Yong-Xiang Wang Jun-Li Yuan Lin Li Zui-Xuan Xiao Association between serum anion gap and all-cause mortality in critically ill patients with diabetic kidney disease: Analysis of the MIMIC-IV database. PLoS ONE |
| title | Association between serum anion gap and all-cause mortality in critically ill patients with diabetic kidney disease: Analysis of the MIMIC-IV database. |
| title_full | Association between serum anion gap and all-cause mortality in critically ill patients with diabetic kidney disease: Analysis of the MIMIC-IV database. |
| title_fullStr | Association between serum anion gap and all-cause mortality in critically ill patients with diabetic kidney disease: Analysis of the MIMIC-IV database. |
| title_full_unstemmed | Association between serum anion gap and all-cause mortality in critically ill patients with diabetic kidney disease: Analysis of the MIMIC-IV database. |
| title_short | Association between serum anion gap and all-cause mortality in critically ill patients with diabetic kidney disease: Analysis of the MIMIC-IV database. |
| title_sort | association between serum anion gap and all cause mortality in critically ill patients with diabetic kidney disease analysis of the mimic iv database |
| url | https://doi.org/10.1371/journal.pone.0329269 |
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