Acute kidney injury (AKI) in patients with diabetic ketoacidosis (DKA)—a complication of Type 2, or diabetes mellitus (DM)—is the leading risk factor associated with increased mortality. A study published in BMC Nephrology examined the frequency, risk factors, and mortality in DKA patients with AKI and confirmed an association with rapid progressive CKD in patients with DKA.*

Background information

Diabetic ketoacidosis (DKA) is a severe and potentially life-threatening complication of diabetes mellitus. DKA is the leading cause of hospitalization and mortality among diabetic patients. DKA may be accompanied by increased urination, weakness, deep gasping breathing, abdominal pain, and other symptoms, and symptoms tend to come on rapidly.

Acute kidney injury (AKI), previously referred to as acute renal failure, is an abrupt loss of kidney function that develops within seven days. AKI occurs due to kidney damage caused by decreased blood flow to the kidneys (kidney ischemia). There are various symptoms associated with AKI—the most frequent of which are headaches, nausea, fatigue, and a loss of appetite.       

Research and investigation details

A team of researchers in China investigated the frequency, risk factors, and mortality in DKA patients with AKI. The group included 179 patients who received a DKA diagnosis from 2012 to 2018. The main risk factors of AKI in patients with DKA are aging, increased blood glucose and uric acid, decreased blood albumin and pH, and pre-existing CKD.

Results and conclusions

Follow-up after hospital discharge with the study’s patients showed a significant difference between DAK patients with and without AKI. DKA patients with AKI had more than a two-fold reduction in glomerular filtration rate (GFR), which measures renal function, compared with DKA patients without AKI.

The investigation confirmed that the aforementioned risk factors contribute to the development of AKI in DKA patients. Moreover, the study concluded that AKI, including advanced stages of AKI, is associated with rapid progressive CKD and long-term mortality in DKA.

*Chen, J., Zeng, H., Zhu, M., Huang, Q., et al. (2020, Feb.12). “The incidence, risk factors, and long-term outcomes of acute kidney injury in hospitalized diabetic ketoacidosis patients.” BMC Nephrology.