Frequency and Risk Factors of Acute Kidney Injury During Diabetic Ketoacidosis in Children and Association With Neurocognitive Outcomes | Zendy

Sage R. Myers | Zendy; Nicole Glaser | Zendy; Jennifer L. Trainor | Zendy; Lise E. Nigrovic | Zendy; Aris Garro | Zendy; Leah Tzimenatos | Zendy; Kimberly S. Quayle | Zendy; Maria Y. Kwok | Zendy; Arleta Rewers | Zendy; Michael J. Stoner | Zendy; Jeff E. Schunk | Zendy; Julie K. McManemy | Zendy; Kathleen Brown | Zendy; Andrew D. DePiero | Zendy; Cody S. Olsen | Zendy; T. Charles Casper | Zendy; Simona Ghetti | Zendy; Nathan Kuppermann | Zendy

Open Access

Frequency and Risk Factors of Acute Kidney Injury During Diabetic Ketoacidosis in Children and Association With Neurocognitive Outcomes

Author(s) -

Sage R. Myers,

Nicole Glaser,

Jennifer L. Trainor,

Lise E. Nigrovic,

Aris Garro,

Leah Tzimenatos,

Kimberly S. Quayle,

Maria Y. Kwok,

Arleta Rewers,

Michael J. Stoner,

Jeff E. Schunk,

Julie K. McManemy,

Kathleen Brown,

Andrew D. DePiero,

Cody S. Olsen,

T. Charles Casper,

Simona Ghetti,

Nathan Kuppermann

Publication year - 2020

Publication title -

jama network open

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 3.278

H-Index - 39

ISSN - 2574-3805

DOI - 10.1001/jamanetworkopen.2020.25481

Subject(s) - medicine , diabetic ketoacidosis , acute kidney injury , type 1 diabetes , odds ratio , diabetes mellitus , kidney disease , creatinine , pediatrics , ketoacidosis , renal replacement therapy , insulin , endocrinology

Key Points Question What are the mechanisms, risk factors, and outcomes associated with acute kidney injury (AKI) during pediatric diabetic ketoacidosis (DKA)? Findings In this cohort study using data from 1359 DKA episodes in a large, multicenter, prospective study of fluid treatment during DKA, AKI occurred in 43% of episodes and was associated with greater acidosis and greater circulatory volume depletion. Children who had AKI were more likely to have subtle cognitive impairment during DKA and lower IQ at longer-term follow-up. Meaning These findings suggest that AKI is frequent in pediatric DKA and there is a pattern of multiorgan dysfunction during childhood DKA with the possibility of common pathophysiologic mechanisms.

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