Challenging Management of Refractory Metabolic Acidosis and Acute Kidney Injury in a Child with Diabetic Ketoacidosis
Citation Information :
Challenging Management of Refractory Metabolic Acidosis and Acute Kidney Injury in a Child with Diabetic Ketoacidosis. Indian J Crit Care Med 2020; 24 (6):475-476.
Diabetic ketoacidosis (DKA) is the most serious complication of type I diabetes mellitus (DM) in children. Majority of these patients respond to fluid resuscitation, insulin, and supportive measures and rarely require renal replacement therapy. Here, we report the case of a young girl with DKA with severe refractory metabolic acidosis and acute kidney injury (AKI) and was successfully managed with renal replacement therapy.
Wolfsdorf JI, Glaser N, Agus M, Fritsch M, Hanas R, Rewers A, et al. ISPAD Clinical Practice Consensus Guidelines 2018: diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatr Diabetes 2018;19(Suppl 27):155–177. DOI: 10.1111/pedi.12701.
Foster DW, McGarry JD. The metabolic derangements and treatment of diabetic ketoacidosis. N Engl J Med 1983;309(3):159–169. DOI: 10.1056/NEJM198307213090307.
Mitchell JH, Wildenthal K, Johnson Jr RL. The effects of acid-base disturbances on cardiovascular and pulmonary function. Kidney Int 1972;1(5):375–389. DOI: 10.1038/ki.1972.48.
Kraut JA, Kurtz I. Use of base in the treatment of severe acidemic states. Am J Kidney Dis 2001;38(4):703–727. DOI: 10.1053/ajkd.2001. 27688.
Hursh BE, Ronsley R, Islam N, Mammen C, Panagiotopoulos C. Acute kidney injury in children with type I diabetes hospitalized for diabetic ketoacidosis. JAMA Pediatr 2017;171(5):e170020. DOI: 10.1001/jamapediatrics.2017.0020.
Chua HR, Schneider A, Bellomo R. Bicarbonate in diabetic ketoacidosis - a systematic review. Ann Intensive Care 2011;1(1):23. DOI: 10.1186/2110-5820-1-23.
Singh H, Krishna RHS, Jain A, Sharma N. Peritoneal dialysis for the rescue in critical refractory metabolic acidosis in diabetic ketoacidosis. J Family Med Prim Care 2019;8(5):1792–1793. DOI: 10.4103/jfmpc.jfmpc_138_19.
Agha A, Nawaz S, Saleem M, Jones S, Ahmed A. Haemofiltration as a treatment option in refractory life-threatening diabetic ketoacidosis. Endocr Abstr 2015;38:88. DOI: 10.1530/endoabs.38.P88.
Bukkar F, Andriana N, Fadil RMR, Widiasta A. Acute kidney injury as a severe complication of diabetic ketoacidosis in children: a case report. Int J Pediatr Endocrinol 2013;2013(Suppl 1):6. DOI: 10.1186/1687-9856-2013-S1-P6.
Parajuli B, Kumar AS, Baalaaji M, Williams V. Acute kidney injury in children with diabetic ketoacidosis: a real concern. Pediatr Crit Care Med 2019;20(6):590–591. DOI: 10.1097/PCC.0000000000001928.
