P0145 / #1860: RISK FACTORS AND OUTCOMES OF ACUTE KIDNEY INJURY IN CHILDREN WITH DIABETIC KETOACIDOSIS IN PEDIATRIC INTENSIVE CARE UNIT AT A TERTIARY CARE CENTER

Abstract

Aims & Objectives: To identify the risk factors and outcomes of Acute Kidney Injury (AKI) in children with Diabetic Ketoacidosis (DKA) admitted in PICU of a tertiary care hospital. Methods: We did a chart review of children aged 1 month to 17 years, admitted with a diagnosis of DKA in PICU between January, 2018- October, 2019. Data collection included demographic, clinical, laboratory and outcome related variables. AKI was defined as using Kidney Disease Improving Global Outcomes serum creatinine criteria. Data were analysed using Stata 11 software. Results: Out of 22 children admitted with DKA in PICU, 7 (31.8%) children developed AKI during the hospital stay. Among them, 6 (85.7%) had AKI at admission while one (14.3%) had AKI at 72 hours. 4 (57.1%) had AKI Stage 1, 2 (28.6%) had AKI Stage 2 and 1 (14.3%) had AKI stage 3. All 7 children with AKI recovered with hydration alone with median duration of recovery of 48 hrs (IQR-12, 192 hrs) without need of renal replacement therapy. Serum sodium at admission, pH and bicarbonate at 24 hours and presence of shock at admission were associated with AKI (p value<0.05 for all). Children with AKI had prolonged acidosis, increased need for mechanical ventilation, cerebral edema and longer PICU stay. However, AKI was not associated with increased mortality in our study. Conclusions: All children with AKI and DKA recovered with hydration alone. Serum sodium at admission, pH and bicarbonate at 24 hours and presence of shock at admission predicted AKI in children with DKA.