Association between stress hyperglycemia ratio (SHR) and the risk of acute kidney injury in patients with chronic kidney disease: analysis of the MIMIC-IV database

Abstract Background Stress hyperglycemia ratio (SHR) is a novel indicator used to evaluate the severity of SH. This study aimed to explore the association between SHR and the risk of AKI and death among individuals with chronic kidney disease (CKD). Methods This retrospective cohort investigation so...

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Main Authors: Jinliang Li, Lianqu Wang, Jiule Zhang, Xiaoguang Li, Zhiling Jiao
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Nephrology
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Online Access:https://doi.org/10.1186/s12882-025-04212-1
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author Jinliang Li
Lianqu Wang
Jiule Zhang
Xiaoguang Li
Zhiling Jiao
author_facet Jinliang Li
Lianqu Wang
Jiule Zhang
Xiaoguang Li
Zhiling Jiao
author_sort Jinliang Li
collection DOAJ
description Abstract Background Stress hyperglycemia ratio (SHR) is a novel indicator used to evaluate the severity of SH. This study aimed to explore the association between SHR and the risk of AKI and death among individuals with chronic kidney disease (CKD). Methods This retrospective cohort investigation sourced data from the Medical Information Mart for Intensive Care-IV (MIMIC IV2.2) repository. The primary endpoint was AKI incidence, while secondary endpoints included in-hospital mortality and renal replacement therapy (RRT). The correlation of SHR with the likelihood of AKI in CKD patients was assessed utilizing restricted cubic spline (RCS) and Cox proportional hazards models. Then using Kaplan-Meier survival curves to analyze endpoint differences across varying SHR levels. Results Among 2,500 CKD patients, 795 (31.8%) developed AKI during hospitalization. Cox proportional hazards analysis indicated a positive association between SHR and AKI incidence. The RCS model showed an approximately linear relationship, with higher SHR linked to increased AKI risk. In addition, Kaplan-Meier survival analysis unveiled notable distinctions in three endpoints across cohorts of patients characterized by varying SHR levels. Conclusions SHR emerges as a dependable and autonomous indicator for predicting AKI occurrence and unfavorable renal outcomes in individuals with CKD. Clinical trial number Not applicable.
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institution Kabale University
issn 1471-2369
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publishDate 2025-07-01
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series BMC Nephrology
spelling doaj-art-a9966da08b154c30b33e7c7c0b5262b12025-08-20T03:37:28ZengBMCBMC Nephrology1471-23692025-07-0126111410.1186/s12882-025-04212-1Association between stress hyperglycemia ratio (SHR) and the risk of acute kidney injury in patients with chronic kidney disease: analysis of the MIMIC-IV databaseJinliang Li0Lianqu Wang1Jiule Zhang2Xiaoguang Li3Zhiling Jiao4Department of Urology, The First Affiliated Hospital of Henan UniversityDepartment of Urology, The First Affiliated Hospital of Henan UniversityDepartment of Urology, The First Affiliated Hospital of Henan UniversityDepartment of Urology, The First Affiliated Hospital of Henan UniversityDepartment of Urology, The First Affiliated Hospital of Henan UniversityAbstract Background Stress hyperglycemia ratio (SHR) is a novel indicator used to evaluate the severity of SH. This study aimed to explore the association between SHR and the risk of AKI and death among individuals with chronic kidney disease (CKD). Methods This retrospective cohort investigation sourced data from the Medical Information Mart for Intensive Care-IV (MIMIC IV2.2) repository. The primary endpoint was AKI incidence, while secondary endpoints included in-hospital mortality and renal replacement therapy (RRT). The correlation of SHR with the likelihood of AKI in CKD patients was assessed utilizing restricted cubic spline (RCS) and Cox proportional hazards models. Then using Kaplan-Meier survival curves to analyze endpoint differences across varying SHR levels. Results Among 2,500 CKD patients, 795 (31.8%) developed AKI during hospitalization. Cox proportional hazards analysis indicated a positive association between SHR and AKI incidence. The RCS model showed an approximately linear relationship, with higher SHR linked to increased AKI risk. In addition, Kaplan-Meier survival analysis unveiled notable distinctions in three endpoints across cohorts of patients characterized by varying SHR levels. Conclusions SHR emerges as a dependable and autonomous indicator for predicting AKI occurrence and unfavorable renal outcomes in individuals with CKD. Clinical trial number Not applicable.https://doi.org/10.1186/s12882-025-04212-1Stress hyperglycemia ratioCKDAcute kidney injuryMortalityMIMIC-IV database
spellingShingle Jinliang Li
Lianqu Wang
Jiule Zhang
Xiaoguang Li
Zhiling Jiao
Association between stress hyperglycemia ratio (SHR) and the risk of acute kidney injury in patients with chronic kidney disease: analysis of the MIMIC-IV database
BMC Nephrology
Stress hyperglycemia ratio
CKD
Acute kidney injury
Mortality
MIMIC-IV database
title Association between stress hyperglycemia ratio (SHR) and the risk of acute kidney injury in patients with chronic kidney disease: analysis of the MIMIC-IV database
title_full Association between stress hyperglycemia ratio (SHR) and the risk of acute kidney injury in patients with chronic kidney disease: analysis of the MIMIC-IV database
title_fullStr Association between stress hyperglycemia ratio (SHR) and the risk of acute kidney injury in patients with chronic kidney disease: analysis of the MIMIC-IV database
title_full_unstemmed Association between stress hyperglycemia ratio (SHR) and the risk of acute kidney injury in patients with chronic kidney disease: analysis of the MIMIC-IV database
title_short Association between stress hyperglycemia ratio (SHR) and the risk of acute kidney injury in patients with chronic kidney disease: analysis of the MIMIC-IV database
title_sort association between stress hyperglycemia ratio shr and the risk of acute kidney injury in patients with chronic kidney disease analysis of the mimic iv database
topic Stress hyperglycemia ratio
CKD
Acute kidney injury
Mortality
MIMIC-IV database
url https://doi.org/10.1186/s12882-025-04212-1
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