{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T12:02:08Z","timestamp":1784548928124,"version":"3.55.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Sepsis-associated acute kidney injury (SA-AKI) raises mortality risk, while the independent links of pre-existing diabetes mellitus (DM) and in-hospital glycemic status to SA-AKI remain unclear. This study explored their correlations with early SA-AKI among sepsis patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective cohort enrolled 6,974 pathogen-positive adult sepsis patients admitted to ICUs from 2023 to 2026. We used pre-existing DM as the primary exposure and time-weighted average glucose as the secondary marker. Multiple adjustment methods including propensity score matching (PSM) and inverse probability weighting (IPW) were adopted to reduce confounding bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      After enrolling 6,947 septic ICU patients, multivariate logistic regression identified pre-existing DM as an independent risk factor for early SA-AKI (adjusted OR\u202f=\u202f2.54, 95% CI 2.25\u20132.86,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001). The protective glycemic range was 6\u201311\u202fmmol\/L for diabetic patients (adjusted OR\u202f=\u202f0.88, 95% CI 0.78\u20130.98,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.025) and 8\u201313\u202fmmol\/L for non-diabetic patients (adjusted OR\u202f=\u202f0.55, 95% CI 0.48\u20130.62,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001). PSM, IPW and doubly robust estimation all validated these consistent associations. Abnormal glucose showed weak predictive power for SA-AKI (AUC 0.60-0.61). Higher time-weighted glucose correlated with advanced AKI stages and increased in-hospital mortality in mild-to-moderate SA-AKI patients. Diabetic SA-AKI patients had higher proportions of stage 1 and stage 3 AKI without significant difference in overall in-hospital mortality compared with non-diabetic counterparts. Matched SA-AKI patients suffered longer ICU\/hospital stays, more organ support use and higher hospital mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Common pathogenic organisms had higher detection rates in SA-AKI cases. Pre-existing DM was positively correlated with early SA-AKI. Targeted in-hospital glycemic intervals were linked to lower SA-AKI risk, which supports individualized glucose monitoring for sepsis patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1878791","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T11:10:24Z","timestamp":1784545824000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of diabetes mellitus and glucose level control on early sepsis-associated acute kidney injury: a multicenter retrospective observational study"],"prefix":"10.3389","volume":"13","author":[{"given":"Lina","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Tianjin Geriatrics Institute, Tianjin Medical University General Hospital","place":["Tianjin, China"]},{"name":"Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Baotou Medical College","place":["Baotou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuoyan","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Third Affiliated Hospital of Inner Mongolia Medical University","place":["Baotou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Chifeng Municipal Hospital, Chifeng Clinical Medical College of Inner Mongolia Medical University","place":["Chifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Chifeng Municipal Hospital, Chifeng Clinical Medical College of Inner Mongolia Medical University","place":["Chifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Chifeng Municipal Hospital, Chifeng Clinical Medical College of Inner Mongolia Medical University","place":["Chifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaopeng","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Emergency, Henan Provincial People\u2019s Hospital, Zhengzhou University People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongming","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, Liaocheng People\u2019s Hospital","place":["Liaocheng, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Tianjin Geriatrics Institute, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongwang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital of Tianjin Medical University","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital of Tianjin Medical University","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"k4891","DOI":"10.1136\/bmj.k4891","article-title":"Sepsis associated acute kidney injury","volume":"9","author":"Poston","year":"2019","journal-title":"BMJ"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1007\/s00134-023-07138-0","article-title":"Sepsis-associated acute kidney injury in the intensive care unit: incidence, patient characteristics, timing, trajectory, treatment, and associated outcomes. 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