Chloride as a Prognostic Factor in Children with Diabetic Ketoacidosis: A Retrospective Cohort Study
Introduction: In the management of Diabetic Ketoacidosis (DKA), importance is given to electrolytes such as sodium and potassium, but not chloride. There is evidence that high chloride levels can lead to Acute Kidney Injury (AKI). However, chloride as a prognostic factor has not been thoroughly...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2024-01-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/18947/67410_CE[Ra1]_F(IS)_QC&Ref(AN_SS)_PF1(R1_DK)_PFA(RI_KM)_PN(KM).pdf |
| _version_ | 1797353334078701568 |
|---|---|
| author | Preethi Suresh Suresh Rangaraj Prasanna Raju Subash Sundar |
| author_facet | Preethi Suresh Suresh Rangaraj Prasanna Raju Subash Sundar |
| author_sort | Preethi Suresh |
| collection | DOAJ |
| description | Introduction: In the management of Diabetic Ketoacidosis
(DKA), importance is given to electrolytes such as sodium and
potassium, but not chloride. There is evidence that high chloride
levels can lead to Acute Kidney Injury (AKI). However, chloride
as a prognostic factor has not been thoroughly investigated.
Aim: To evaluate the role of chloride as a prognostic factor in
the treatment of children with DKA.
Materials and Methods: This retrospective cohort study
collected data from 22 children with severe DKA, aged under 14
years, admitted to the Department of Paediatrics, SRM Medical
College Hospital and Research Centre, Chennai, Tamil Nadu,
India, between January 2016 and October 2020. Data included
demographic details, blood glucose, arterial blood gas, renal
function tests, serum electrolytes at admission and at 24 hours,
and outcome parameters. All children received regular monitoring
and standard treatment as per the International Society for
Paediatric and Adolescent Diabetes (ISPAD) guidelines. The
children were divided into two groups: Recovery within 48 hours
(Group-A) and more than 48 hours (Group-B). Electrolyte and
renal parameters after 24 hours of treatment were compared.
Univariate analysis was performed using Statistical Package
for Social Sciences (SPSS) version 21.0. Student's t-test, Chisquare test, and odds ratio were used for statistical analysis. A
p-value of <0.05 was considered significant.
Results: Among the 22 children, 50% recovered within 48
hours, while the remaining half took more than 48 hours. A total
of 13 had hyperchloraemia at 24 hours (59%). The mean serum
chloride at 24 hours was 115.91 mmol/L in Group-B compared
to 106.09 mmol/L in Group-A (p=0.0079*). Two developed AKI,
requiring renal replacement therapy and ventilatory support,
and eventually died.
Conclusion: In the present study, children with severe DKA
who developed hyperchloraemia after 24 hours of admission,
following fluid resuscitation with 0.9% normal saline and
subsequent standard treatment, took a longer time to recover. |
| first_indexed | 2024-03-08T13:28:42Z |
| format | Article |
| id | doaj.art-a3669bc7e5184664b186558ad854cd2d |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-03-08T13:28:42Z |
| publishDate | 2024-01-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-a3669bc7e5184664b186558ad854cd2d2024-01-17T11:25:55ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2024-01-011801222510.7860/JCDR/2024/67410.18947Chloride as a Prognostic Factor in Children with Diabetic Ketoacidosis: A Retrospective Cohort StudyPreethi Suresh0Suresh Rangaraj1Prasanna Raju2Subash Sundar3Postgraduate, Department of Paediatrics, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India.Associate Professor, Department of Paediatrics, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India.Professor, Department of Paediatrics, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India.Professor and Head, Department of Paediatrics, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India.Introduction: In the management of Diabetic Ketoacidosis (DKA), importance is given to electrolytes such as sodium and potassium, but not chloride. There is evidence that high chloride levels can lead to Acute Kidney Injury (AKI). However, chloride as a prognostic factor has not been thoroughly investigated. Aim: To evaluate the role of chloride as a prognostic factor in the treatment of children with DKA. Materials and Methods: This retrospective cohort study collected data from 22 children with severe DKA, aged under 14 years, admitted to the Department of Paediatrics, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India, between January 2016 and October 2020. Data included demographic details, blood glucose, arterial blood gas, renal function tests, serum electrolytes at admission and at 24 hours, and outcome parameters. All children received regular monitoring and standard treatment as per the International Society for Paediatric and Adolescent Diabetes (ISPAD) guidelines. The children were divided into two groups: Recovery within 48 hours (Group-A) and more than 48 hours (Group-B). Electrolyte and renal parameters after 24 hours of treatment were compared. Univariate analysis was performed using Statistical Package for Social Sciences (SPSS) version 21.0. Student's t-test, Chisquare test, and odds ratio were used for statistical analysis. A p-value of <0.05 was considered significant. Results: Among the 22 children, 50% recovered within 48 hours, while the remaining half took more than 48 hours. A total of 13 had hyperchloraemia at 24 hours (59%). The mean serum chloride at 24 hours was 115.91 mmol/L in Group-B compared to 106.09 mmol/L in Group-A (p=0.0079*). Two developed AKI, requiring renal replacement therapy and ventilatory support, and eventually died. Conclusion: In the present study, children with severe DKA who developed hyperchloraemia after 24 hours of admission, following fluid resuscitation with 0.9% normal saline and subsequent standard treatment, took a longer time to recover.https://www.jcdr.net/articles/PDF/18947/67410_CE[Ra1]_F(IS)_QC&Ref(AN_SS)_PF1(R1_DK)_PFA(RI_KM)_PN(KM).pdfacute kidney injuryhyperchloraemiahyperchloraemic acidosisprognosis |
| spellingShingle | Preethi Suresh Suresh Rangaraj Prasanna Raju Subash Sundar Chloride as a Prognostic Factor in Children with Diabetic Ketoacidosis: A Retrospective Cohort Study Journal of Clinical and Diagnostic Research acute kidney injury hyperchloraemia hyperchloraemic acidosis prognosis |
| title | Chloride as a Prognostic Factor in Children with Diabetic Ketoacidosis: A Retrospective Cohort Study |
| title_full | Chloride as a Prognostic Factor in Children with Diabetic Ketoacidosis: A Retrospective Cohort Study |
| title_fullStr | Chloride as a Prognostic Factor in Children with Diabetic Ketoacidosis: A Retrospective Cohort Study |
| title_full_unstemmed | Chloride as a Prognostic Factor in Children with Diabetic Ketoacidosis: A Retrospective Cohort Study |
| title_short | Chloride as a Prognostic Factor in Children with Diabetic Ketoacidosis: A Retrospective Cohort Study |
| title_sort | chloride as a prognostic factor in children with diabetic ketoacidosis a retrospective cohort study |
| topic | acute kidney injury hyperchloraemia hyperchloraemic acidosis prognosis |
| url | https://www.jcdr.net/articles/PDF/18947/67410_CE[Ra1]_F(IS)_QC&Ref(AN_SS)_PF1(R1_DK)_PFA(RI_KM)_PN(KM).pdf |
| work_keys_str_mv | AT preethisuresh chlorideasaprognosticfactorinchildrenwithdiabeticketoacidosisaretrospectivecohortstudy AT sureshrangaraj chlorideasaprognosticfactorinchildrenwithdiabeticketoacidosisaretrospectivecohortstudy AT prasannaraju chlorideasaprognosticfactorinchildrenwithdiabeticketoacidosisaretrospectivecohortstudy AT subashsundar chlorideasaprognosticfactorinchildrenwithdiabeticketoacidosisaretrospectivecohortstudy |