Acute kidney injury as a severe complication of diabetic ketoacidosis in children: a case report

Results A 12-year-old girl from a rural area was admitted to our pediatric emergency with decreased consciousness. We reviewed there was a history of polyuria, polydipsia and marked weight loss. When she arrived at hospital, she was very ill, comatose state, severe dehydration and typical Kussmaul breathing. Her heart rate was 140/min with thread pulse, low blood pressure, dry mucous membranes, sunken eyes, poor capillary return, and cold fingers. Laboratory analysis showed her blood glucose level was 890 mg/dl, severe metabolic acidosis and urine ketones 3+. The patient was resuscitated with iv fluid as soon as possible, followed by insulin and potassium chloride. On day 2 she developed oliguric and her serum creatinin and urea levels were 2.25 and 124 mg/dl that impressed as acute kidney injury. After fluid restriction she had persistent oliguric, increased serum creatinin and urea up to 7.34 and 234 mg/dl warranted initiation of peritoneal dialysis. After peritoneal dialysis and DKA management she showed a good improvement.