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Acute Kidney Injury in Pediatric Diabetic Ketoacidosis

Eun Mi Yang1, Hyun Gyung Lee1, Ka Young Oh2

  • 1Department of Pediatrics, Chonnam National University Hospital and Medical School, Gwangju, South Korea.

Indian Journal of Pediatrics
|November 19, 2020
PubMed

Insights

Acute kidney injury (AKI) is common in children with type 1 diabetes mellitus (T1DM) and diabetic ketoacidosis (DKA). Longer T1DM duration and high anion gap predict severe AKI in pediatric DKA.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Diabetes Research

Background:

  • Diabetic ketoacidosis (DKA) is a serious complication of type 1 diabetes mellitus (T1DM).
  • Acute kidney injury (AKI) is a potential complication of DKA, particularly in pediatric populations.

Purpose of the Study:

  • To determine the incidence and clinical features of AKI in children with T1DM and DKA.
  • To identify risk factors associated with AKI development in this patient group.

Main Methods:

  • A retrospective study was conducted over 15 years at a single Korean center.
  • Children aged 18 years or younger with T1DM and DKA were enrolled and categorized based on AKI presence.
  • Data analysis included logistic regression to identify independent predictors of severe AKI.

Main Results:

  • AKI occurred in 77.8% of DKA episodes (70/90), with 20% stage 1, 43.3% stage 2, and 14.4% stage 3.
  • Higher white blood cell count and anion gap, and lower serum bicarbonate levels were observed in the AKI group.
  • A longer duration of T1DM (OR, 1.225) and a high anion gap (OR, 1.130) were independent predictors of severe AKI.

Conclusions:

  • AKI is a frequent complication in pediatric patients with T1DM experiencing DKA.
  • The duration of T1DM and elevated anion gap levels are significant risk factors for developing severe AKI in this vulnerable population.
Abstract

Keywords:
Acute kidney injuryChildrenDiabetes mellitusDiabetic ketoacidosis

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