ArticlePediatric diabetes2021
Tubular injury in diabetic ketoacidosis: Results from the diabetic kidney alarm study.
Article in Pediatric diabetes, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- The role of cystatin C in kidney injury in children and adolescents with type 1 diabetes mellitus: a systematic review.Jornal brasileiro de nefrologiaPooled it
- Acute kidney injury in children and adolescents with diabetic ketoacidosis managed with aggressive initial volume resuscitation.Clinics (Sao Paulo, Brazil) · 2026Article
- Kidney injury molecule-1 as a biomarker of diabetic kidney disease in children with type 1 diabetes: a systematic review and quantitative synthesis.Childhood kidney diseases · 2026Review
- Comments on "association between triglyceride-glucose index upon admission and the subsequent occurrence of acute kidney injury in adult patients with diabetic ketoacidosis: a single-center retrospective cohort study".Annals of medicine · 2025Article
- Transient renal tubular injury among children and adolescents during diabetic ketoacidosis: severity, renal perfusion, and urinary netrin- 1 interplay.European journal of pediatrics · 2025Article
- Acidosis at Diagnosis of Type 1 Diabetes Mellitus: Relation With Kidney Function.Pediatric diabetes · 2025Article
- Association between glycemic variability and acute kidney injury incidence in patients with cerebral infarction: an analysis of the MIMIC-IV database.Frontiers in endocrinology · 2025Article
- Association between visceral adiposity index and incidence of diabetic kidney disease in adults with diabetes in the United States.Scientific reports · 2024Article
- Acute and chronic kidney complications in children with type 1 diabetes mellitus.Pediatric nephrology (Berlin, Germany) · 2023Review
- Acute kidney injury in diabetes mellitus: Epidemiology, diagnostic, and therapeutic concepts.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2023Review
- Determinants of acute kidney injury in children with new onset type 1 diabetes: A cohort study of children aged <15 years: Auckland, New Zealand (2006-2016).Endocrinology, diabetes & metabolism · 2022Article
- Aminoaciduria and metabolic dysregulation during diabetic ketoacidosis: Results from the diabetic kidney alarm (DKA) study.Journal of diabetes and its complications · 2022Article
- The Impact of an Elevated Uric Acid Level on the Prevalence of Coronary Artery Disease in Pancreas Transplant Candidates with Type 1 Diabetes: A Cross Sectional Study.Journal of clinical medicine · 2022Article
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Authors and funding
18 authors at 7 institutions in 3 countries.
Funding
Abstract
objectiveGlomerular injury is a recognized complication of diabetic ketoacidosis (DKA), yet the tubular lesions are poorly understood. The aim of this prospective study was to evaluate the presence and reversibility of tubular injury during DKA in children with type 1 diabetes (T1D). RESEARCH DESIGN AND
methodsBlood and urine samples were collected from 40 children with DKA (52% boys, mean age 11 ± 4 years, venous pH 7.2 ± 0.1, glucose 451 ± 163 mg/dL) at three timepoints: 0-8 and 12-24 h after starting insulin, and 3 months after discharge. Mixed-effects models evaluated the changes in tubular injury markers over time (neutrophil gelatinase-associated lipocalin [NGAL], kidney injury molecule 1 [KIM-1], and interleukin 18 [IL-18]). We also evaluated the relationships among the tubular injury biomarkers, copeptin, a vasopressin surrogate, and serum uric acid (SUA).
resultsSerum NGAL, KIM-1, and IL-18 were highest at 0-8 h (306.5 ± 45.9 ng/mL, 128.9 ± 10.1 pg/mL, and 564.3 ± 39.2 pg/mL, respectively) and significantly decreased over 3 months (p = 0.03, p = 0.01, and p < 0.001, respectively). There were strong relationships among increases in copeptin and SUA and rises in tubular injury biomarkers. At 0-8 h, participants with acute kidney injury (AKI) [17%] showed significantly higher concentrations of tubular injury markers, copeptin, and SUA.
conclusionsDKA was characterized by tubular injury, and the degree of injury associated with elevated copeptin and SUA. Tubular injury biomarkers, copeptin and SUA may be able to predict AKI in DKA.
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