دورية أكاديمية
Incidence and factors associated with acute kidney injury among children with type 1 diabetes hospitalized with diabetic ketoacidosis: A prospective study.
العنوان: | Incidence and factors associated with acute kidney injury among children with type 1 diabetes hospitalized with diabetic ketoacidosis: A prospective study. |
---|---|
المؤلفون: | Hegab AM; Pediatrics Department, Faculty of Medicine, Sohag University, Sohag, Egypt., Khalil FF; Pediatrics Department, Faculty of Medicine, Sohag University, Sohag, Egypt., Abosedera MM; Pediatrics Department, Faculty of Medicine, Sohag University, Sohag, Egypt. |
المصدر: | Pediatric diabetes [Pediatr Diabetes] 2022 Sep; Vol. 23 (6), pp. 783-791. Date of Electronic Publication: 2022 Jun 10. |
نوع المنشور: | Journal Article; Observational Study |
اللغة: | English |
بيانات الدورية: | Publisher: Munksgaard Country of Publication: Denmark NLM ID: 100939345 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1399-5448 (Electronic) Linking ISSN: 1399543X NLM ISO Abbreviation: Pediatr Diabetes Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Copenhagen : Munksgaard, c2000- |
مواضيع طبية MeSH: | Acute Kidney Injury*/epidemiology , Acute Kidney Injury*/etiology , Acute Kidney Injury*/therapy , Diabetes Mellitus, Type 1*/complications , Diabetes Mellitus, Type 1*/diagnosis , Diabetes Mellitus, Type 1*/epidemiology , Diabetic Ketoacidosis*/epidemiology , Diabetic Ketoacidosis*/etiology , Diabetic Ketoacidosis*/therapy, Child ; Chlorides ; Creatinine ; Humans ; Incidence ; Prospective Studies ; Retrospective Studies |
مستخلص: | Background and Objectives: Acute kidney injury (AKI) is frequent among critically ill children. This study aimed to assess the incidence and factors associated with AKI among children with type 1 diabetes mellitus (T1DM) hospitalized with diabetic ketoacidosis (DKA). Methods: This prospective observational study was conducted at Sohag University Hospital, Egypt over 1 year. Children aged 6 months to 12 years, diagnosed with T1DM and hospitalized with the criteria of DKA were included. The study participants received intravenous fluid therapy and intravenous insulin infusion for DKA management. Serum creatinine levels were measured at admission, 24 and 48 h after admission. AKI was defined and staged using the Kidney Disease Improving Global Outcomes serum creatinine criteria. Results: The study included 265 DKA episodes in 240 participants. AKI was found in 110 (41.5%) DKA episodes. Moderated to severe AKI developed in 41 (15.5%) episodes. Multivariate regression analysis revealed that age (adjusted odds ratio = 0.78, 95% confidence interval (CI): 0.69-0.89, p < 0.001), Glasgow-Coma scale (GCS) < 14 at admission (adjusted odds ratio = 4.66, 95% CI: 1.66-13.14, p = 0.004) and serum chloride level at 12 h (adjusted odds ratio = 1.10, 95% CI: 1.02-1.18, p = 0.01) were the most significant factors associated with moderate to severe AKI development. Conclusions: AKI is common among T1DM children hospitalized with DKA. Younger age, low GCS at hospital admission and increased serum chloride level during DKA management were associated with increased risk for moderate to severe AKI development. (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.) |
References: | Nyenwe EA, Kitabchi AE. The evolution of diabetic ketoacidosis: an update of its etiology, pathogenesis and management. Metabolism. 2016;65(4):507-521. doi:10.1016/j.metabol.2015.12.007. Hursh BE, Ronsley R, Islam N, Mammen C, Panagiotopoulos C. Acute kidney injury in children with type 1 diabetes hospitalized for diabetic ketoacidosis. JAMA Pediatr. 2017;171(5):e170020. doi:10.1001/jamapediatrics.2017.0020. Wolfsdorf JI, Glaser N, Agus M, et al. ISPAD clinical practice consensus guidelines 2018: diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatr Diabetes. 2018;19:155-177. doi:10.1111/pedi.12701. Basu RK, Devarajan P, Wong H, Wheeler DS. An update and review of acute kidney injury in pediatrics. Pediatr Crit Care Med. 2011;12(3):339-347. doi:10.1097/PCC.0b013e3181fe2e0b. Andreoli SP. Acute kidney injury in children. Pediatr Nephrol. 2009;24(2):253-263. doi:10.1007/s00467-008-1074-9. Kaddourah A, Basu RK, Bagshaw SM, Goldstein SL. Epidemiology of acute kidney injury in critically ill children and young adults. N Engl J Med. 2017;376:11-20. doi:10.1056/NEJMoa1611391. Basu RK. Dynamic biomarker assessment: a diagnostic paradigm to match the AKI syndrome. Front Pediatr. 2020;7:535. doi:10.3389/fped.2019.00535. Kellum JA, Lameire N, Aspelin P, et al. Kidney disease: improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2(1):1-138. Thomas ME, Blaine C, Dawnay A, et al. The definition of acute kidney injury and its use in practice. Kidney Int. 2015;87(1):62-73. doi:10.1038/ki.2014.328. Feldman-Kiss D, Li D, Cleve R, Sinclair G, Dubland JA, Wang L. Interference of ketone bodies on laboratory creatinine measurement in children with DKA: a call for change in testing practices. Pediatr Nephrol. 2022;37(6):1347-1353. doi:10.1007/s00467-021-05324-0. Baalaaji M, Jayashree M, Nallasamy K, Singhi S, Bansal A. Predictors and outcome of acute kidney injury in children with diabetic ketoacidosis. Indian Pediatr. 2018;55(4):311-314. Weissbach A, Zur N, Kaplan E, Kadmon G, Gendler Y, Nahum E. Acute kidney injury in critically ill children admitted to the PICU for diabetic ketoacidosis. A retrospective study. Pediatr Crit Care Med. 2019;20(1):e10-e14. doi:10.1097/PCC.0000000000001758. Huang S-K, Huang C-Y, Lin C-H, et al. Acute kidney injury is a common complication in children and adolescents hospitalized for diabetic ketoacidosis. PLoS One. 2020;15(10):e0239160. doi:10.1371/journal.pone.0239160. Myers SR, Glaser NS, Trainor JL, et al. Frequency and risk factors of acute kidney injury during diabetic ketoacidosis in children and association with neurocognitive outcomes. JAMA Netw Open. 2020;3(12):e2025481. doi:10.1001/jamanetworkopen.2020.25481. Yang EM, Lee HG, Oh KY, Kim CJ. Acute kidney injury in pediatric diabetic ketoacidosis. Indian J Pediatr. 2021;88(6):568-573. doi:10.1007/s12098-020-03549-9. Donaghue KC, Marcovecchio ML, Wadwa RP, et al. ISPAD clinical practice consensus guidelines 2018: microvascular and macrovascular complications in children and adolescents. Pediatr Diabetes. 2018;19(Suppl 27):262-274. doi:10.1111/pedi.12742. Teasdale G, Jennett B. Assessment of coma and impaired consciousness: a practical scale. Lancet. 1974;304(7872):81-84. doi:10.1016/s0140-6736(74)91639-0. Ugale J, Mata A, Meert KL, Sarnaik AP. Measured degree of dehydration in children and adolescents with type 1 diabetic ketoacidosis. Pediatr Crit Care Med. 2012;13(2):e103-e107. doi:10.1097/PCC.0b013e3182231493. Jayashree M, Williams V, Iyer R. Fluid therapy for pediatric patients with diabetic ketoacidosis: current perspectives. Diabetes Metab Syndr Obes. 2019;12:2355-2361. doi:10.2147/DMSO.S194944. Chromý V, Rozkosná K, Sedlák P. Determination of serum creatinine by Jaffe method and how to calibrate to eliminate matrix interference problems. Clin Chem Lab Med. 2008;46(8):1127-1133. doi:10.1515/CCLM.2008.224. Schwartz G, Haycock G, Edelmann C, Spitzer A. A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics. 1976;58(2):259-263. Schwartz GJ, Feld LG, Langford DJ. A simple estimate of glomerular filtration ratein full-term infants during the first year of life. J Pediatr. 1984;104(6):849-854. doi:10.1016/s0022-3476(84)80479-5. Schmidt RL, Straseski JA, Raphael KL, Adams AH, Lehman CM. A risk assessment of the Jaffe vs enzymatic method for creatinine measurement in an outpatient population. PLoS One. 2015;10(11):e0143205. doi:10.1371/journal.pone.0143205. Kemperman FA, Weber JA, Gorgels J, van Zanten AP, Krediet RT, Arisz L. The influence of ketoacids on plasma creatinine assays in diabetic ketoacidosis. J Intern Med. 2000;248(6):511-517. doi:10.1046/j.1365-2796.2000.00768.x. Schwartz GJ, Work DF. Measurement and estimation of GFR in children and adolescents. Clin J Am Soc Nephrol. 2009;4(11):1832-1843. doi:10.2215/CJN.01640309. Finlay S, Bray B, Lewington AJ, et al. Identification of risk factors associated with acute kidney injury in patients admitted to acute medical units. Clin Med (Lond). 2013;13(3):233-238. doi:10.7861/clinmedicine.13-3-233. Usher-Smith JA, Thompson MJ, Sharp SJ, Walter FM. Factors associated with the presence of diabetic ketoacidosis at diagnosis of diabetes in children and young adults: a systematic review. BMJ. 2011;343:d4092. doi:10.1136/bmj.d4092. Poovazhagi V. Risk factors for mortality in children with diabetic ketoacidosis from developing countries. World J Diabetes. 2014;5(6):932-938. doi:10.4239/wjd.v5.i6.932. Lee SA, Cozzi M, Bush EL, Rabb H. Distant organ dysfunction in acute kidney injury: a review. Am J Kidney Dis. 2018;72(6):846-856. doi:10.1053/j.ajkd.2018.03.028. Lo W, O'Donnell M, Tancredi D, Orgain M, Glaser N. Diabetic ketoacidosis in juvenile rats is associated with reactive gliosis and activation of microglia in the hippocampus. Pediatr Diabetes. 2016;17(2):127-139. doi:10.1111/pedi.12251. Stenson EK, Cvijanovich NZ, Allen GL, et al. Hyperchloremia is associated with acute kidney injury in pediatric patients with septic shock. Intensive Care Med. 2018;44(11):2004-2005. doi:10.1007/s00134-018-5368-5. Barhight MF, Brinton JT, Soranno DE, Faubel S, Mourani PM, Gist KM. Effects of hyperchloremia on renal recovery in critically ill children with acute kidney injury. Pediatr Nephrol. 2020;35(7):1331-1339. doi:10.1007/s00467-020-04513-7. Ahmed HM, Elnaby HRH, Hodeib M. The relationship between hyperchloremia and acute kidney injury in pediatric diabetic ketoacidosis and its impact on clinical outcomes. Pediatr Nephrol. 2022;37(6):1407-1413. doi:10.1007/s00467-021-05279-2. Wilcox CS. Regulation of renal blood flow by plasma chloride. J Clin Invest. 1983;71(3):726-735. doi:10.1172/jci110820. Chowdhury AH, Cox EF, Francis ST, Lobo DN. A randomized, controlled, double-blind crossover study on the effects of 2-L infusions of 0.9% saline and plasma-lyte® 148 on renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers. Ann Surg. 2012;256(1):18-24. doi:10.1097/SLA.0b013e318256be72. Huang JX, Casper TC, 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(2):169-175. doi:10.1001/jamapediatrics.2021.5038. |
فهرسة مساهمة: | Keywords: acute kidney injury; children; diabetic ketoacidosis; type 1 diabetes |
المشرفين على المادة: | 0 (Chlorides) AYI8EX34EU (Creatinine) |
تواريخ الأحداث: | Date Created: 20220601 Date Completed: 20220809 Latest Revision: 20220902 |
رمز التحديث: | 20240628 |
DOI: | 10.1111/pedi.13370 |
PMID: | 35644034 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1399-5448 |
---|---|
DOI: | 10.1111/pedi.13370 |