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BMC Nephrology
Published in: BMC Nephrology 1/2020

Open Access 01-12-2020 | Acute Kidney Injury | Research article

The incidence, risk factors, and long-term outcomes of acute kidney injury in hospitalized diabetic ketoacidosis patients

Authors: Junzhe Chen, Honghui Zeng, Xia Ouyang, Mingsheng Zhu, Qiuyan Huang, Wenjuan Yu, Li Ling, Hui-yao Lan, Anping Xu, Ying Tang

Published in: BMC Nephrology | Issue 1/2020

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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. The current study aimed to investigate the incidence rate, risk factors, long-term renal outcomes, and mortality in DKA patients with AKI.

Methods

A total of 179 patients diagnosed with DKA at Sun Yat-sen Memorial Hospital from January 2012 to January 2018 were included in the analysis. AKI was diagnosed according to the 2012 KDIGO criteria. Risk factors, long-term renal outcomes, and mortality were analyzed by logistic regression and Cox proportional hazards models.

Results

Among 179 DKA patients, 98 patients (54.75%) were diagnosed as AKI. Aging; increased blood glucose, serum uric acid and white blood cells; decreased serum pH and albumin; coma; and preexisting chronic kidney disease (CKD) were risk factors of AKI in patients with DKA. During follow-up, DKA patients with AKI showed more than a two-fold decline in eGFR within 1 year after discharge from the hospital when compared with non-AKI DKA patients. Furthermore, AKI was also an independent risk factor for poor long-term renal outcomes and mortality in DKA patients.

Conclusions

Multiple risk factors contribute to the development of AKI in DKA patients. AKI and advanced AKI stage are associated with rapid progressive CKD and long-term mortality in patients with DKA.
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Metadata
Title
The incidence, risk factors, and long-term outcomes of acute kidney injury in hospitalized diabetic ketoacidosis patients
Authors
Junzhe Chen
Honghui Zeng
Xia Ouyang
Mingsheng Zhu
Qiuyan Huang
Wenjuan Yu
Li Ling
Hui-yao Lan
Anping Xu
Ying Tang
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2020
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-020-1709-z

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