A new study published in the Indian Journal of Pediatrics stated that Type 1 diabetes mellitus (T1DM) – a common metabolic disorder in children, requires an early detection of complications. Diabetic ketoacidosis (DKA) – an acute complication, accounts for about 20-40% of cases in new-onset T1DM, and needs urgent hospitalization and management. 

The authors elaborated that DKA occurs in those who stop their insulin treatment or are not treated adequately during illnesses. Globally, the overall incidence of AKI was deduced to be 27%, with severe AKI in 11.6% of children. DKA is a serious condition causing mortality in these patients; the incidence of AKI in DKA was reported to be between 35-56.5%. 

This article summarized the potential risk factors for the development of AKI children with T1DM, which are – volume deletion during ketoacidosis, large volume fluid administration as 0.9% sodium chloride leading to hyperchloremia, high blood glucose, acidosis, raised uric acid, glucose-corrected sodium level, higher initial serum-urea-nitrogen, increased heart rate and pre-existing chronic kidney disease.

Source: Indian Journal of Pediatrics.2021;88:542–543. doi: 10.1007/s12098-021-03762-0