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Acute Kidney Injury in Children with Type 1 Diabetes Mellitus Hospitalized for Diabetic Ketoacidosis: A Retrospective

Shaila Pachapure1, Jasmine Kandagal2, Manjunath Revanasiddappa2

  • 1Jawaharlal Nehru Medical College (KAHER - KLE Academy of Higher Education and Research), Belagavi, Karnataka, India.

Journal of the ASEAN Federation of Endocrine Societies
|December 8, 2025
PubMed

Insights

Diabetic ketoacidosis (DKA) in children with type 1 diabetes often leads to acute kidney injury (AKI). Identifying risk factors like severe hyperglycemia and acidosis is crucial for early intervention and improved outcomes.

Area of Science:

  • Pediatrics
  • Nephrology
  • Endocrinology

Background:

  • Diabetic ketoacidosis (DKA) is a common presentation of type 1 diabetes in children.
  • DKA can lead to acute kidney injury (AKI) due to severe dehydration, acidosis, and shock.
  • Identifying risk factors for AKI in DKA is essential for timely management.

Purpose of the Study:

  • To determine the incidence of AKI in children hospitalized for DKA.
  • To compare clinical parameters between DKA patients with and without AKI.
  • To identify risk factors associated with AKI in pediatric DKA.

Main Methods:

  • Retrospective review of DKA admissions in children with type 1 diabetes.
  • AKI diagnosis based on KDIGO-2012 criteria.
  • Statistical analysis including Chi-square, Independent t-test, and multivariate logistic regression.

Main Results:

  • 40.63% of children with DKA developed AKI (13 out of 32).
  • Higher heart rate, respiratory rate, leukocyte count, severe hyperglycemia, severe acidosis, hyperchloremia, and shock at admission were associated with AKI.
  • AKI resolved in 10 patients with fluid management, but 3 required dialysis.

Conclusions:

  • A significant proportion of children with DKA experience AKI, prolonging acidosis and hospital stay.
  • Clinical parameters such as severe hyperglycemia, acidosis, and shock are key risk factors for AKI in pediatric DKA.
  • Early identification of these risk factors can guide management strategies to prevent AKI in children with type 1 diabetes and DKA.
Abstract

Keywords:
acute kidney injurydiabetic ketoacidosishyperchloremiaketone bodies

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