Nickan Research Institute Journal of Renal Injury Prevention 2345-2781 15 3 2026 09 01 Prevalence of electrolyte imbalances and acute kidney injury in type 1 diabetic children with diabetic ketoacidosis; a retrospective cross-sectional study e38724 e38724 10.34172/jrip.2026.38724 EN Hossein Emad Momtaz https://orcid.org/0000-0002-6865-7143 Marzieh Zahabi https://orcid.org/0009-0002-8878-6660 Abbas Moradi https://orcid.org/0000-0003-4994-0936 Zahra Razavi https://orcid.org/0000-0001-5318-9087 Journal Article 10.34172/jrip.2026.38724 2025 11 08 2026 03 23 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.