DKA and the kidneys -
Marcin, MD, MPH UC Davis Health, University of California Davis ; Jeff E. Schunk, MD; Mary Murray, MD; Jared Henricksen, MD; Brad Poss, MD; Cody S.
Olsen, MS; T. Charles Casper, PhD; and J. McManemy, MD, MPH; Jake A. Kushner, MD; and Laura L. Nigrovic, MD, MPH; Joseph I. Wolfsdorf, MD; and Michael S.
Brown, MD; Fran R. Quayle, MD; Neil H. White, MD, CDE; and Nikoleta S. Trainor, MD; Donald Zimmerman, MD; and Denise Goodman, MD, MS Ann and Robert H. DePiero, MD; Jonathan E. Bennett, MD; Daniel A.
Doyle, MD; and Meg A. Frizzola, MD A. DuPont Hospital for Children, Thomas Jefferson University ; Maria Y.
Disclaimer: The content and conclusions of this article are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by the Health Resources and Services Administration, the Department of Health and Human Services, or the US government.
full text icon Full Text. Download PDF Comment. Top of Article Key Points Abstract Introduction Methods Results Discussion Conclusions Article Information References.
Figure 1. Patient Flow Diagram. View Large Download. Figure 2. Timing of Initial Detection of Acute Kidney Injury and Impaired Mental Status.
Table 1. Patient and DKA Episode Characteristics. Table 2. Factors Associated With Acute Kidney Injury a. Table 3. Associations Between AKI During DKA Treatment and Neurocognitive Outcomes.
Sensitivity of Adjusted Odds Ratios of Acute Kidney Injury AKI to Estimation of Assumed Baseline Kidney Function eTable 2.
Multivariable Logistic Regression Model of AKI Among Patients With Information About Dehydration Severity eTable 3. Ghetti S, Lee JK, Sims CE, Demaster DM, Glaser NS. Diabetic ketoacidosis and memory dysfunction in children with type 1 diabetes.
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Glaser NS, Ghetti S, Casper TC, Dean JM, Kuppermann N; Pediatric Emergency Care Applied Research Network PECARN DKA FLUID Study Group. Pediatric diabetic ketoacidosis, fluid therapy, and cerebral injury: the design of a factorial randomized controlled trial.
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Pourghasem M, Shafi H, Babazadeh Z. Histological changes of kidney in diabetic nephropathy. See More About Emergency Medicine Critical Care Medicine Diabetes Diabetes and Endocrinology Acid Base, Electrolytes, Fluids Pediatrics Acute Kidney Injury Nephrology. Sign Up for Emails Based on Your Interests Select Your Interests Customize your JAMA Network experience by selecting one or more topics from the list below.
Get the latest research based on your areas of interest. Weekly Email. Monthly Email. Save Preferences. Privacy Policy Terms of Use. This Issue. Views 12, Citations View Metrics. X Facebook More LinkedIn. Cite This Citation Myers SR , Glaser NS , Trainor JL, et al.
Original Investigation. December 4, Sage R. Myers, MD, MSCE 1,2 ; Nicole S. Glaser, MD 3 ; Jennifer L. Trainor, MD 4,5 ; et al Lise E. Nigrovic, MD, MPH 6,7 ; Aris Garro, MD, MPH 8,9 ; Leah Tzimenatos, MD 10 ; Kimberly S. Quayle, MD 11,12 ; Maria Y.
Kwok, MD, MPH 13,14 ; Arleta Rewers, MD, PhD 15,16 ; Michael J. Stoner, MD 17,18 ; Jeff E. Schunk, MD 19 ; Julie K. McManemy, MD, MPH 20,21 ; Kathleen M. Brown, MD 22,23 ; Andrew D. DePiero, MD 24,25 ; Cody S. Olsen, MS 19 ; T. Charles Casper, PhD 19 ; Simona Ghetti, PhD 26 ; Nathan Kuppermann, MD, MPH 3,10 ; for the Pediatric Emergency Care Applied Research Network PECARN DKA FLUID Study Group.
duPont Hospital for Children, Wilmington, Delaware. visual abstract icon Visual Abstract. Key Points Question What are the mechanisms, risk factors, and outcomes associated with acute kidney injury AKI during pediatric diabetic ketoacidosis DKA?
Statistical Analyses. Frequency of AKI. Factors Associated With AKI. Univariable Analyses. Multivariable and Sensitivity Analyses. Risk of AKI With Repeated DKA Episodes. Associations Between AKI and Cerebral Injury. Back to top Article Information. Access your subscriptions.
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Acute kidney injury in intensive care unit patients: a comparison between the RIFLE and the acute kidney injury network classifications. Download references. We would like to thank Mr. Thomas Mak at the Chinese University of Hong Kong for the English assistance and we also have invited American Journal Expert for the English editing.
This study was presented as a poster at the 56th ERA-EDTA Congress with the number SP on June 15, in Budapest, Hungary.
This study was supported by grants from National Natural Scientific Foundation of China and the Routine Clinical Research Funds of Sun Yat-sen Memorial Hospital SYS-C which paid for the statistical consulting and language polishing service.
The funding body had no role in the design of the study, collection, analysis and interpretation of data and in writing the manuscript. Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Yanjiang West Road, Guangzhou, China. Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China. Department of Medicine and Therapeutics, Li KaShing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.
You can also search for this author in PubMed Google Scholar. Conceived and designed the study: YT, AX. Collected Data: JC, HZ, XO, MZ, QH, WY. Analyzed and interpreted the data: JC, YT, HZ, MZ. Performed statistical analysis: JC, HZ, LL. Contributed to the writing of the manuscript: YT, JC, HZ, XO, WY, HYL.
Revised the manuscript: YT, JC, HZ, AX, HYL. All authors read and approved the final manuscript. Correspondence to Anping Xu or Ying Tang. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The changes of SCr and eGFR level between AKI and non-AKI group in DKA patients during follow-up period.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4. Reprints and permissions. Chen, J. et al. The incidence, risk factors, and long-term outcomes of acute kidney injury in hospitalized diabetic ketoacidosis patients.
BMC Nephrol 21 , 48 Download citation. Received : 13 May Accepted : 30 January Published : 12 February Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article.
Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background Emerging evidence has demonstrated that acute kidney injury AKI is an important risk factor associated with increased morbidity and mortality in diabetic ketoacidosis DKA patients.
Methods A total of patients diagnosed with DKA at Sun Yat-sen Memorial Hospital from January to January were included in the analysis. Results Among DKA patients, 98 patients Conclusions Multiple risk factors contribute to the development of AKI in DKA patients.
Background Diabetic ketoacidosis DKA , a severe complication of diabetes mellitus DM , is the leading cause of hospitalization, morbidity and mortality in patients with DM [ 1 , 2 ].
Procedures We reviewed the hospital electronic records and collected the anonymized baseline characteristics of DKA patients, including demographic characteristic, disease history, physical examination, and biological examination data.
Measurements Baseline characteristics Electronic records were reviewed, and detailed information of DKA patients including sex, age, height, weight, body mass index BMI , type of DM, history of cardiovascular disease CVD and preexisting CKD, was recorded.
Statistical analysis The baseline characteristics of the DKA patients were summarized by descriptive statistics. Results A total of hospitalized patients diagnosed with DKA at Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January to January were systematically retrospectively reviewed.
Table 1 The baseline characteristics of DKA patients between non-AKI and AKI group Full size table. Table 2 Risk factors of AKI in DKA patients Full size table. Table 3 Predictors of the long-term renal outcomes in DKA patients using Cox proportional hazards model a Full size table.
Full size image. Table 4 Predictors of the mortality in DKA patients using Cox proportional hazards model a Full size table. Discussion The incidence of DM has steadily increased worldwide, and DM is becoming the leading cause of chronic noncommunicable diseases as well as the predominant pathogenic factor of CKD worldwide [ 11 ].
Conclusions AKI is a severe complication of DKA, and age; Glu, SUA and WBCs levels; pH and serum Alb; coma; and preexisting CKD are associated with AKI. Abbreviations AKI: Acute kidney injury Alb: Albumin ARF: Acute renal failure BMI: Body mass index CKD: Chronic kidney disease CVD: Cardiovascular disease DBP: Diastolic blood pressure DKA: Diabetic ketoacidosis DM: Diabetes mellitus eGFR: Estimated glomerular filtration rate Glu: Blood glucose HbA1c: Glycosylated hemoglobin ICU: Intensive care unit KDIGO: Kidney disease improving global outcomes MDRD: Modification of diet in renal disease SBP: Systolic blood pressure SCr: Serum creatine Scradm: Admission SCr Scrmin: Minimum value of SCr SUA: Serum uric acid WBCs: White blood cells.
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Article PubMed PubMed Central Google Scholar Download references. Acknowledgments We would like to thank Mr. Funding This study was supported by grants from National Natural Scientific Foundation of China and the Routine Clinical Research Funds of Sun Yat-sen Memorial Hospital SYS-C which paid for the statistical consulting and language polishing service.
Author information Author notes Junzhe Chen, Honghui Zeng, Xia Ouyang and Mingsheng Zhu contributed equally to this work. View author publications. Consent for publication Not applicable.
Competing interests The authors declare that they have no competing interests. Supplementary information. Additional file 1: Table S1. Rights and permissions Open Access This article is distributed under the terms of the Creative Commons Attribution 4.
Diabetic kidney disease kidnesy a major thf of end-stage kidney failure. Does acute Non-irritant fabrics injury during diabetic ketoacidosis in children with type 1 diabetes increase the kirneys DKA and the kidneys future kidney disease? One DKA and the kidneys the Bod Pod body composition analysis causes of end-stage kidney failure yhe diabetic kidney disease. Recent investigations have found that a high frequency of acute kidney injury during diabetic ketoacidosis occurs among children. A new investigation examined the long-term risk of such occurrences on future diabetic kidney disease in children who have type 1 diabetes. The investigators performed a retrospective review of medical records that included children with type 1 diabetes who also had 1 or more urine albumin levels that were measured during the course of routine care for diabetes from January to December
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