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Acute Kidney Injury in Pediatric Diabetic Ketoacidosis

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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To assess the incidence and clinical characteristics of acute kidney injury (AKI) and identify the associated risk factors for AKI in children with type 1 diabetes mellitus (T1DM) and diabetic ketoacidosis (DKA).

Methods

This was a retrospective study performed over 15 y in a single Korean center. Children aged ≤18-y-old with T1DM and DKA were enrolled and divided into 2 groups according to the presence of AKI.

Results

This study included 90 episodes of DKA in 58 children with T1DM. AKI occurred in a total of 70 hospitalizations (77.8%) of 44 children: 18 (20.0%) with stage 1 AKI, 39 (43.3%) with stage 2 AKI, and 13 (14.4%) with stage 3 AKI. The number of AKI decreased to 28 (47.4%) and 13 (28.3%) after 12 h and 24 h of admission, respectively. The white blood cell count (P = 0.001) and anion gap levels (P = 0.025) were significantly higher and serum bicarbonate level (P = 0.004) was lower in the AKI group. Logistic regression analysis revealed that a longer duration of TIDM and high anion gap were independent predictors of developing severe AKI in pediatric DKA with T1DM (odds ratio, 1.225, P = 0.013; odds ratio, 1.130, P = 0.038).

Conclusions

AKI frequently occurred in TIDM children with DKA. Longer duration of TIDM and elevated anion gap are associated with occurrence of severe AKI.

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Authors and Affiliations

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

    Eun Mi Yang, Hyun Gyung Lee & Chan Jong Kim

  2. Department of Pediatrics, Jeil Hospital, Yeosu, South Korea

    Ka Young Oh

Authors
  1. Eun Mi Yang
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  2. Hyun Gyung Lee
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  3. Ka Young Oh
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  4. Chan Jong Kim
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Contributions

CJK: Study concept and design; KYO and HGL: Acquisition of data; EMY: Drafting of the manuscript; CJK: Supervision and critical revision of the manuscript for important intellectual content. CJK will act as guarantor for this paper.

Corresponding author

Correspondence to Chan Jong Kim.

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None.

Ethical Approval

The study was approved by the institutional review board of our hospital. (CNUH-2017-306).

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Yang, E.M., Lee, H.G., Oh, K.Y. et al. Acute Kidney Injury in Pediatric Diabetic Ketoacidosis. Indian J Pediatr 88, 568–573 (2021). https://doi.org/10.1007/s12098-020-03549-9

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  • DOI: https://doi.org/10.1007/s12098-020-03549-9

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