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.
Wei et al. (Thu,) studied this question.