Children with type 1 diabetes at risk of acute kidney injury following DKA, study reports

Children with type 1 diabetes who are hospitalised for diabetic ketoacidosis (DKA) are more likely to develop acute kidney injury (AKI), a new study finds.
Acute kidney injury can increase the risk of chronic disease, and children with more severe DKA had a heightened risk of severe AKI.
Researchers from University of British Columbia, Vancouver, Canada say this study is the first to show that acute kidney injury is a frequent complication in DKA in youngsters.
A total of 165 youths with type 1 diabetes aged 18 years and younger were studied, all of whom had been admitted to hospital for DKA between 2008-2013.
Sixty-four per cent developed acute kidney injury, and those with severe DKA were five times more likely to develop severe acute kidney injury.
The study team hypothesise that acute kidney injury may be recognised less in pediatric DKA because children’s weight and height are not considered when interpreting levels of serum creatinine, which increase with AKI.
Senior author Dina Panagiotopoulos, MD, explained to Medscape Medical News: “From this study, we became aware that recognizing acute kidney injury is a challenge, because serum creatinine needs to be interpreted in the context of a child’s height.
“As a result of our findings, we are developing a quick reference card that provides clinicians with a formula utilising the child’s height to determine what their expected normal baseline creatinine would be prior to illness.”
Panagiotopoulos and colleagues have also begun a second study to assess the long-term impact of acute kidney injury in children who have experienced DKA, and the subsequent risk for developing chronic kidney disease.
The study has been published online in JAMA Pediatrics.