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Submitted: 08 Nov 2025
Revision: 22 Dec 2025
Accepted: 23 Mar 2026
ePublished: 15 Apr 2026
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J Renal Inj Prev. 2026;15(3): e38724.
doi: 10.34172/jrip.2026.38724
  Abstract View: 11
  PDF Download: 3

Original

Prevalence of electrolyte imbalances and acute kidney injury in type 1 diabetic children with diabetic ketoacidosis; a retrospective cross-sectional study

Hossein Emad Momtaz 1 ORCID logo, Marzieh Zahabi 2 ORCID logo, Abbas Moradi 3 ORCID logo, Zahra Razavi 1* ORCID logo

1 Department of Pediatrics, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
2 School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
3 Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
*Corresponding Author: Zahra Razavi, Email: Razvizahra@yahoo.com.au

Abstract

Introduction: Children with type 1 diabetes are at increased risk of developing diabetic ketoacidosis (DKA), a life‑threatening complication often accompanied by electrolyte disturbances and kidney injury. Understanding the prevalence and patterns of these metabolic derangements is crucial for improving clinical management and outcomes in pediatric populations.

Objectives: This study aimed to provide insight into the prevalence of electrolyte imbalances and acute kidney injury (AKI) among children with type 1 diabetes with DKA, to highlight key implications for early recognition and intervention.

Materials and Methods: This single-center, retrospective cross-sectional study was conducted at Besat hospital in Hamadan, Iran, over 10 years (2011–2021) and included pediatric and adolescent patients (<18 years) with type 1 diabetes who were hospitalized for acute DKA. Eligible cases were identified from hospital records and extracted. Demographic, clinical, and laboratory information, including electrolyte profiles and renal parameters, was extracted from medical records, and AKI was classified according to KDIGO criteria. All data were entered into structured tables and analyzed descriptively using frequencies and percentages to determine the prevalence of electrolyte disorders and AKI in the study population.

Results: The results indicated that among 94 pediatric patients with DKA, 59 (62.8%) experienced electrolyte disturbances, while 61 (64.9%) developed AKI, with grade 1 being the most frequent stage (39 cases, 63.9%). The most common electrolyte abnormalities were hyponatremia in 16 patients (17%), hyperkalemia in 22 patients (23.4%), and hypocalcemia in 9 patients (9.6%).

Conclusion: Electrolyte disturbances and AKI were common among pediatric patients with DKA, with hyponatremia, hyperkalemia, and grade 1 AKI being the most frequent findings. These results underscore the importance of early detection and close monitoring of metabolic and renal complications in this population.



Implication for health policy/practice/research/medical education:

We found that in pediatric patients with diabetic ketoacidosis (DKA), electrolyte disturbances and acute kidney injury (AKI) were both highly prevalent, with grade 1 AKI representing the most frequent stage. The most common electrolyte abnormalities identified were hyponatremia, hyperkalemia, and hypocalcemia. These findings emphasize the necessity of routine and early monitoring of renal function and electrolyte status in children presenting with DKA. Prompt recognition and correction of these imbalances, particularly hypokalemia and sodium or calcium disturbances, are critical to reducing morbidity and preventing progression of kidney injury. Incorporating standardized protocols for electrolyte surveillance and AKI risk assessment into pediatric DKA management may improve patient outcomes and minimize complications.

Please cite this paper as: Emad Momtaz H, Zahabi M, Moradi A, Razavi Z. Prevalence of electrolyte imbalances and acute kidney injury in type 1 diabetic children with diabetic ketoacidosis; a retrospective cross-sectional study. J Renal Inj Prev. 2026; 15(3): e38724. doi: 10.34172/jrip.2026.38724.

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