SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Renal Endocrinology
Association between triglyceride glucose index and risk of acute kidney injury in critically ill patients: A systematic review and meta-analysis
Provisionally accepted
Maoying Wei1
Kaixuan Chu2
Chan Wu1
Haoshuo Wang1
Aijing Li1
Jingyi Guo1
Anning Sun1Xin Gu1
Yuyun Fan2*Zhijuan Tan3*Yanbing Gong1*- 1Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- 2Linyi People's Hospital, Linyi, China
- 3Xingtai Hospital of Traditional Chinese Medicine, Xingtai, China
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Background: Acute kidney injury (AKI) is a common and serious complication among critically ill patients. The triglyceride-glucose (TyG) index, a simple surrogate marker of insulin resistance (IR), has recently emerged as a potential predictor of AKI in this population. However, the existing evidence has not yet been systematically evaluated. Objective: To systematically evaluate the association between the TyG index and the risk of AKI in critically ill patients. Methods: A comprehensive literature search was performed across PubMed, Embase, and Web of Science from inception to October 31, 2025, for observational studies reporting the relationship of the TyG index with AKI risk among critically ill patients. Following predefined eligibility criteria, two authors independently undertook the screening process, data extraction using a standardized data collection form, and risk of bias evaluation. All statistical analyses were carried out with RevMan 5.3 and Stata 16.0. Results: A total of 18 studies involving 81,479 participants were included in the meta-analysis. The results demonstrated that a higher TyG index was significantly associated with an increased risk of AKI, with a pooled odds ratio (OR) of 1.39 (95% CI: 1.22-1.58, P < 0.00001) and a pooled hazard ratio (HR) of 1.43 (95% CI: 1.14-1.78, P = 0.002). This positive association remained consistent across most subgroups stratified by factors such as sex, age, hypertension, chronic kidney disease, and diabetes. However, the association did not reach statistical significance in the Black population or in subgroups with or without atrial fibrillation. Conclusion: The TyG index was significantly associated with the risk of AKI in critically ill patients, with higher TyG index levels correlating with an increased risk of AKI. Systematic Review Registration: https://www.crd.york.ac.uk/prospero, identifier CRD420251232658.
Keywords: Acute Kidney Injury, Insulin Resistance, Meta-analysis, Systematic review, Triglyceride glucose index
Received: 02 Dec 2025; Accepted: 11 Feb 2026.
Copyright: © 2026 Wei, Chu, Wu, Wang, Li, Guo, Sun, Gu, Fan, Tan and Gong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yuyun Fan
Zhijuan Tan
Yanbing Gong
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