Risk factors of acute kidney injury in children with diabetic ketoacidosis

Related Experiment Video

Updated: Jun 16, 2026

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
10:31

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice

Published on: May 2, 2025

Naseem Alyahyawi1,2, Dalal Alghamdi2, Ahlam Almahmoudi2

  • 1Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia.

BMC Nephrology
|May 22, 2025
PubMed

Insights

Acute kidney injury (AKI) is common in children hospitalized with diabetic ketoacidosis (DKA). Risk factors include poorly controlled T1D, severe DKA, and high heart rate, with many experiencing persistent kidney issues.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Critical Care Medicine

Background:

  • Acute kidney injury (AKI) in pediatric patients is associated with adverse short- and long-term health outcomes.
  • The incidence of AKI in children with type 1 diabetes (T1D) admitted for diabetic ketoacidosis (DKA) is understudied.

Purpose of the Study:

  • To determine the incidence of AKI in pediatric patients hospitalized for DKA.
  • To identify clinical and biochemical markers associated with AKI development in this population.

Main Methods:

  • A retrospective review of 373 pediatric patients (2012-2022) at a tertiary hospital.
  • AKI diagnosis based on KDIGO serum creatinine criteria.
  • Logistic regression analysis to identify risk factors for AKI.

Main Results:

  • 80.2% of patients developed AKI, with higher incidence in severe DKA.
  • Risk factors included higher heart rate, longer duration of T1D, previous DKA episodes, and severe DKA.
  • 44% of AKI patients had persistent acute kidney disease at discharge; AKI patients had longer hospital stays.

Conclusions:

  • AKI is prevalent in pediatric DKA admissions.
  • Identifying risk factors like severe DKA and elevated heart rate is crucial for early intervention.
  • Persistent AKD in a significant portion of patients underscores AKI's morbidity and the need for close monitoring.
Abstract

Keywords:
Acute kidney injuryDiabetes ketoacidosisIncidence ratePediatricType 1 diabetes

More Related Videos

Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock07:48

Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock

Published on: October 28, 2022

Related Concept Videos

Diabetic Ketoacidosis l: Introduction01:25

Diabetic Ketoacidosis l: Introduction

DefinitionDiabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus, characterized by a triad of hyperglycemia (blood glucose >250 mg/dL), ketonemia or ketonuria, and metabolic acidosis (arterial pH <7.30 and serum bicarbonate <18 mEq/L). It results from insulin deficiency combined with elevated levels of counterregulatory hormones—glucagon, catecholamines, cortisol, and growth hormone—leading to increased lipolysis, hepatic ketone production, and...
Diabetic Ketoacidosis ll: Pathophysiology01:22

Diabetic Ketoacidosis ll: Pathophysiology

Diabetic ketoacidosis (DKA) is a metabolic emergency characterized by hyperglycemia, ketonemia, and metabolic acidosis. It results from severe insulin deficiency and an excess of counterregulatory hormones, leading to uncontrolled lipolysis, ketogenesis, and widespread electrolyte and fluid disturbances.Pathophysiology The central event in DKA is a profound loss of insulin action. Without insulin, glucose uptake in insulin-dependent tissues is impaired, while hepatic glucose production...
Complications of Diabetes Mellitus01:22

Complications of Diabetes Mellitus

Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to insulin deficiency, resistance, or both. Prolonged hyperglycemia disrupts metabolic homeostasis and leads to acute and chronic complications.Acute ComplicationsAcute complications result from sudden metabolic imbalance.Diabetic ketoacidosis (DKA) mainly appears in type 1 diabetes but may also develop in type 2 diabetes, particularly under extreme stress. It arises from severe insulin deficiency,...
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...