Predictors of mortality and poor renal outcomes in adults with diabetic ketoacidosis

Document Type : Original Article

Authors

1 Department of endocrinology at the internal medicine ,faculty of medicine, Port-Said University, Egypt

2 Department of Endocrinology at the internal medicine, faculty of medicine, Port-Said University, Egypt.

3 Department of Clinical Pathology , Faculty of Medicine, Port-Said University, Egypt.

Abstract

Background: Diabetes mellitus has an overshooting incidence nowadays and diabetic ketoacidosis is one of its common complications. Acute kidney injury is a common complication of diabetic ketoacidosis that adversely affect mortality and morbidity. Early detection with subsequent management of such factors can successfully modify the overall prognosis.
Aim of The study: to detect risk factors associated with the development of acute kidney injury in adults with diabetic ketoacidosis and the impact of these factors on mortality and morbidity.
Methods: A prospective study was carried out on ALSALAM General Hospital in the period between August 2021 to April 2022. The study included 60 subjects admitted to ICU with diabetic ketoacidosis (based on Blood Glucose level >250mg/dL, presence of ketonemia or ketonuria, arterial PH <7.3, anion gap > 10, Hco3 < 18 meq/L). Predictors of mortality and renal outcome were studied in this cohort of patients.
Results: Age, comorbidities (e.g., recent stroke), urinary neutrophilic gelatinous lipocalin, glycemic control, the degree of acidosis, estimated glomerular filtration rate, and uric acid were significantly correlated with acute kidney injury, while higher blood glucose was associated with higher mortality.
Conclusion: Early detection of multiple risk factors associated with acute kidney injury in patients with diabetic ketoacidosis can improve the prognosis and decrease overall morbidity and mortality.

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