Neutrophil Gelatinase Associated Lipocalin and Kidney Injury Molecule-1 As Biomarkers of AKI in Children With DKA

Type 1 diabetes mellitus (T1DM) is a common, chronic, metabolic disorder that has significant consequences for physical and emotional development . The incidence of TIDM is steadily increasing in nearly all parts of the world by about 2-5% per year . Diabetic ketoacidosis (DKA) is the most serious complication of TIDM and results from metabolic abnormalities due to a severe deficiency of insulin or insulin effectiveness. Similar to diabetes, DKA has an increasing incidence and more frequently occurs in children. DKA occurs in 20-40% of children with new-onset diabetes and in children with known diabetes who omit insulin doses or who do not successfully manage during intercurrent illness (1). Although the inpatient mortality rates of DKA are generally very low (5, 6) ,DKA is the leading with TIDM (7). DKA is associated with numerous acid-base, hydration and electrolyte derangements. Accompanied by both volume depletion and subsequent massive fluid-rehydration treatment upon presentation, children with DKA potentially have a high risk for acute kidney injury (AKI). For decades, nonconsensual definitions of AKI were used, making it difficult to obtain an accurate evaluation of the epidemiological studies