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).


Journal

Endocrinology, diabetes & metabolism
ISSN: 2398-9238
Titre abrégé: Endocrinol Diabetes Metab
Pays: England
ID NLM: 101732442

Informations de publication

Date de publication:
09 2022
Historique:
revised: 26 06 2022
received: 12 04 2022
accepted: 17 07 2022
pubmed: 6 8 2022
medline: 16 9 2022
entrez: 5 8 2022
Statut: ppublish

Résumé

Acute kidney injury (AKI) may contribute to the risk of diabetic kidney disease, however, there have been limited studies of the incidence of AKI in well-defined populations of children with type 1 diabetes. The aim was to quantify AKI in children presenting with new onset type 1 diabetes from the regional paediatric diabetes service, Auckland, New Zealand. A retrospective analysis of a prospectively identified cohort study of children and adolescents presenting from 2006 to 2016 with type 1 diabetes aged <15 years. AKI was defined using Kidney Disease/Improving Global Outcomes serum creatinine criteria. There were 586 subjects: 52% male, with mean (SD) age 8.9 (3.8) years, with 151(25.8%) in diabetic ketoacidosis (DKA). AKI was present in 47%, 278/586, AKI was increased in those with DKA (125/151 (83%) DKA vs. 153/435 (35%) no-DKA). Univariable analysis showed that increased HbA1c, higher glucose levels, lower BMI SDS, lower bicarbonate and pH levels were all associated with AKI (p < .001). In multivariable analysis, AKI was associated with DKA and higher glucose levels independently. The majority of cases were stage 1 (203/278 [73%]), or stage 2 AKI 62/278 (22%). 13/278 (5%) had severe, Stage 3 AKI, and all presented in DKA (13/151 (8%) vs. 0/435 (0%) without DKA, p < .001). In this regional paediatric, cohort AKI is a common complication of children presenting with new onset type 1 diabetes. AKI is independently associated with higher glucose levels and DKA, and all cases of Stage 3 AKI were associated with DKA.

Identifiants

pubmed: 35927794
doi: 10.1002/edm2.362
pmc: PMC9471584
doi:

Substances chimiques

Glucose IY9XDZ35W2

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e362

Informations de copyright

© 2022 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.

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Auteurs

Fiona Pittman (F)

Starship Children's Health, Auckland, New Zealand.
Auckland Medical School, University of Auckland, Auckland, New Zealand.

Harry Di Somma (H)

Starship Children's Health, Auckland, New Zealand.
Auckland Medical School, University of Auckland, Auckland, New Zealand.

William Wong (W)

Starship Children's Health, Auckland, New Zealand.

Chanel Prestidge (C)

Starship Children's Health, Auckland, New Zealand.

Peter Reed (P)

Starship Children's Health, Auckland, New Zealand.

Alistair J Gunn (AJ)

Starship Children's Health, Auckland, New Zealand.
Auckland Medical School, University of Auckland, Auckland, New Zealand.
Department of Physiology, Auckland Medical School, University of Auckland, Auckland, New Zealand.

Craig Jefferies (C)

Starship Children's Health, Auckland, New Zealand.
Liggins institute, University of Auckland, Auckland, New Zealand.
Department of Paediatrics, University of Auckland, Auckland, New Zealand.

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Classifications MeSH