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Urinary catecholamine in children with diabetic ketoacidosis
A Körner1, T Tulassay, M Miltényi
1First Department of Paediatrics, Semmelweis University Medical School, Budapest, Hungary.
Child Nephrology and Urology
|January 1, 1991
Summary
Diabetic ketoacidosis in children elevates urinary catecholamines like norepinephrine and dopamine. Fluid replacement reduces these levels, suggesting their role in kidney function changes during this condition.
Area of Science:
- Pediatric Endocrinology
- Nephrology
- Metabolic Disorders
Background:
- Diabetic ketoacidosis (DKA) is a serious complication of diabetes mellitus.
- DKA is characterized by hyperglycemia, metabolic acidosis, and dehydration.
- The role of catecholamines in DKA pathophysiology, particularly concerning renal function, requires further elucidation.
Purpose of the Study:
- To investigate urinary excretion of catecholamines (norepinephrine, epinephrine, dopamine) in children with DKA.
- To assess the impact of fluid replacement on catecholamine excretion.
- To explore correlations between catecholamine excretion and renal function parameters in DKA.
Main Methods:
- Measurement of urinary norepinephrine, epinephrine, and dopamine excretion in children with DKA.
- Assessment of fluid replacement effects on catecholamine levels.
- Correlation analysis between urinary catecholamine output, creatinine clearance, diuresis, and sodium excretion.
Main Results:
- Markedly elevated urinary catecholamine excretion (norepinephrine, epinephrine, dopamine) at DKA onset.
- Significant decrease in urinary catecholamine excretion following fluid replacement.
- Negative correlation between urinary norepinephrine and creatinine clearance; positive correlations between norepinephrine/dopamine and diuresis; dopamine and sodium excretion.
Conclusions:
- Increased urinary norepinephrine excretion in DKA may contribute to renal hypoperfusion and hypofiltration.
- Elevated renal dopamine production in DKA is linked to characteristic sodium loss.
- Catecholamine modulation is a potential factor in managing renal dysfunction during DKA.