Diabetic kidney disease is among the most important causes of end-stage disease across the globe. While the risk factors for diabetic kidney disease are incompletely defined, recent data has demonstrated that episodes of acute kidney injury occurring during diabetic ketoacidosis in children with type 1 diabetes are considerably linked to the risk of developing microalbuminuria. 

Ina case-control study of 2345 children with type 1 diabetes, acute kidney injury during DKA was significantly associated with increased risk of development of microalbuminuria. This association persisted after adjusting for age at diagnosis of type 1 diabetes and glycemic control. The above data is reflective of a previously unrecognized risk factor for diabetic kidney disease and suggests that more focused efforts are needed to prevent DKA and the occurrence of acute kidney injury during diabetic ketoacidosis. 

Reference: Huang JX, Casper CC, Pitts C, et al. Association of acute kidney injury during diabetic ketoacidosis with risk of microalbuminuria in children with type 1 diabetes. JAMA Pediatr. 2022; 176: 169-175.