{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:17:07Z","timestamp":1783487827689,"version":"3.55.0"},"reference-count":12,"publisher":"Walter de Gruyter GmbH","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2020-0251_abs_001_w2aab3b7c11b1b6b1aab1c16b1Aa\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Although Acute Kidney Injury (AKI) has been described among childhood diabetes ketocidosis (cDKA) there is scarcity of literature on the role of concomitant rhabdomyolysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2020-0251_abs_002_w2aab3b7c11b1b6b1aab1c16b2Aa\">\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>A retrospective chart review was undertaken (2014\u20132018) to identify cDKA who developed AKI and had evidence of rhabdomyolysis defined by serum creatine phosphokinase (CPK)\u00a0&gt;\u00a05 times upper limit of normal.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2020-0251_abs_003_w2aab3b7c11b1b6b1aab1c16b3Aa\">\n                  <jats:title>Result<\/jats:title>\n                  <jats:p>46 cDKA were identified. Ten (22%) developed AKI\u00a0with 6\/10 reaching peak AKI Stage 3 and 8\/10 had co-current rhabdomyolysis. In comparison to non rhabdomyolysis group, cDKA with rhabdomyolysis were at presentation\u00a0significantly more likely to be hypotensive and have higher corrected sodium and calculated osmolality. Subsequently they were more likely to develop lower trough potassium levels during treatment. Five patients, all with rhabdomyolysis, needed dialysis: median duration 9\u00a0days (range 4\u201335). Three children in our cohort died, all from infection complications during treatment, one in AKI only group who did not receive dialysis and two in AKI with rhabdomyolysis on dialysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2020-0251_abs_004_w2aab3b7c11b1b6b1aab1c16b4Aa\">\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Rhabdomyolysis was common among our cohort of cDKA with AKI and was associated with high morbidity and mortality. Rapid flux in electrolytes and osmolality may be important precipitating factors. We recommend larger prospective studies exploring the importance of rhabdomyolysis among cDKA with AKI.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2020-0251","type":"journal-article","created":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T12:27:52Z","timestamp":1602073672000},"page":"251-254","source":"Crossref","is-referenced-by-count":3,"title":["Are we ignoring coexisting rhabdomyolysis as an important aggravating factor for acute kidney injury among childhood diabetic ketoacidosis?"],"prefix":"10.1515","volume":"34","author":[{"given":"Prabhas. P","family":"Giri","sequence":"first","affiliation":[{"name":"Paediatric Intensive Care, Consultant, PICU , Institute of Child Health , Kolkata , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shakil","family":"Akhtar","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care, Consultant, PICU , Institute of Child Health , Kolkata , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Somrita","family":"Laha","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care, Consultant, PICU , Institute of Child Health , Kolkata , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4525-092X","authenticated-orcid":false,"given":"Rajiv","family":"Sinha","sequence":"additional","affiliation":[{"name":"Division of Paediatric Nephrology , Institute of Child Health , Kolkata , India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2020,10,7]]},"reference":[{"key":"2023040100571178219_j_jpem-2020-0251_ref_001_w2aab3b7c11b1b6b1ab2b2b1Aa","doi-asserted-by":"crossref","unstructured":"Kanwal, SK, Bando, A, Kumar, V. Clinical profile of diabetic ketoacidosis in Indian children. Indian J Pediatr 2012;79:901\u20134. https:\/\/doi.org\/10.1007\/s12098-011-0634-3.","DOI":"10.1007\/s12098-011-0634-3"},{"key":"2023040100571178219_j_jpem-2020-0251_ref_002_w2aab3b7c11b1b6b1ab2b2b2Aa","doi-asserted-by":"crossref","unstructured":"Kaddourah, A, Basu, RK, Bagshaw, SM, Goldstein, SL, AWARE Investigators. Epidemiology of acute kidney injury in critically ill children and young adults. N Engl J Med 2017;5:11\u201320. https:\/\/doi.org\/10.1056\/nejmoa1611391.","DOI":"10.1056\/NEJMoa1611391"},{"key":"2023040100571178219_j_jpem-2020-0251_ref_003_w2aab3b7c11b1b6b1ab2b2b3Aa","doi-asserted-by":"crossref","unstructured":"Greenberg, JH, Coca, S, Parikh, CR. Long-term risk of chronic kidney disease and mortality in children after acute kidney injury: a systematic review. BMC Nephrol 2014;15:184. https:\/\/doi.org\/10.1186\/1471-2369-15-184.","DOI":"10.1186\/1471-2369-15-184"},{"key":"2023040100571178219_j_jpem-2020-0251_ref_004_w2aab3b7c11b1b6b1ab2b2b4Aa","doi-asserted-by":"crossref","unstructured":"Hursh, BE, Ronsley, R, Islam, N, Mammen, C, Panagiotopoulos, C. Acute kidney injury in children with type 1 diabetes hospitalizedfor diabetic ketoacidosis. JAMA Pediatr 2017;171:e170020. https:\/\/doi.org\/10.1001\/jamapediatrics.2017.0020.","DOI":"10.1001\/jamapediatrics.2017.0020"},{"key":"2023040100571178219_j_jpem-2020-0251_ref_005_w2aab3b7c11b1b6b1ab2b2b5Aa","doi-asserted-by":"crossref","unstructured":"Baalaaji, M, Jayashree, M, Nallasamy, K, Singhi, S, Bansal, A. Predictors and outcome of acute kidney injury in children with diabetic ketoacidosis. Indian Pediatr 2018;55:311\u201314. https:\/\/doi.org\/10.1007\/s13312-018-1274-8.","DOI":"10.1007\/s13312-018-1274-8"},{"key":"2023040100571178219_j_jpem-2020-0251_ref_006_w2aab3b7c11b1b6b1ab2b2b6Aa","doi-asserted-by":"crossref","unstructured":"Saito, O, Saito, T, Sugase, T, Kusano, E, Nagata, D. Hypothermia and hypokalemia in a patient with diabetic ketoacidosis. Saudi J Kidney Dis Transpl 2015;26:580\u20133. https:\/\/doi.org\/10.4103\/1319-2442.157387.","DOI":"10.4103\/1319-2442.157387"},{"key":"2023040100571178219_j_jpem-2020-0251_ref_007_w2aab3b7c11b1b6b1ab2b2b7Aa","doi-asserted-by":"crossref","unstructured":"Wolfsdorf, JI, Glaser, N, Agus, M, Fritsch, M, Hanas, R, Rewers, A, et al. ISPAD Clinical Practice Consensus guidelines 2018. Diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatr Diabetes 2018;19:155\u201377. https:\/\/doi.org\/10.1111\/pedi.12701.","DOI":"10.1111\/pedi.12701"},{"key":"2023040100571178219_j_jpem-2020-0251_ref_008_w2aab3b7c11b1b6b1ab2b2b8Aa","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO). Acute kidney injury work group KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl 2012;2:1\u2013138."},{"key":"2023040100571178219_j_jpem-2020-0251_ref_009_w2aab3b7c11b1b6b1ab2b2b9Aa","unstructured":"Keltz, E, Khan, FY, Mann, G. Rhabdomyolysis. The role of diagnostic and prognostic factors. Muscl, Ligaments and Tendons J 2013;3:303\u201312. 24596694."},{"key":"2023040100571178219_j_jpem-2020-0251_ref_010_w2aab3b7c11b1b6b1ab2b2c10Aa","doi-asserted-by":"crossref","unstructured":"Poovazhagi, V. Risk factors for mortality in children with diabetic ketoacidosis from developing countries. World J Diabetes 2014;5:932\u20138. https:\/\/doi.org\/10.4239\/wjd.v5.i6.932.","DOI":"10.4239\/wjd.v5.i6.932"},{"key":"2023040100571178219_j_jpem-2020-0251_ref_011_w2aab3b7c11b1b6b1ab2b2c11Aa","doi-asserted-by":"crossref","unstructured":"Orban, J-C, Maizie`re, E-M, Ghaddab, A, Van Obberghen, E, Ichai, C. Incidence and characteristics of acute kidney injury in severe diabetic ketoacidosis. PloS One 2014;9:e110925. https:\/\/doi.org\/10.1371\/journal.pone.0110925.","DOI":"10.1371\/journal.pone.0110925"},{"key":"2023040100571178219_j_jpem-2020-0251_ref_012_w2aab3b7c11b1b6b1ab2b2c12Aa","doi-asserted-by":"crossref","unstructured":"Kutlu, AO, Kara, C, Cetinkaya, S. Rhabdomyolysis without detectable myoglobulinuria due to severe hypophosphatemia in diabetic ketoacidosis. Pediatr Emerg Care 2011;27:537\u20138. https:\/\/doi.org\/10.1097\/pec.0b013e31821dc68a.","DOI":"10.1097\/PEC.0b013e31821dc68a"}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/view\/journals\/jpem\/ahead-of-print\/article-10.1515-jpem-2020-0251\/article-10.1515-jpem-2020-0251.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2020-0251\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2020-0251\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T17:24:37Z","timestamp":1680369877000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2020-0251\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,7]]},"references-count":12,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,12,14]]},"published-print":{"date-parts":[[2021,2,23]]}},"alternative-id":["10.1515\/jpem-2020-0251"],"URL":"https:\/\/doi.org\/10.1515\/jpem-2020-0251","relation":{},"ISSN":["2191-0251","0334-018X"],"issn-type":[{"value":"2191-0251","type":"electronic"},{"value":"0334-018X","type":"print"}],"subject":[],"published":{"date-parts":[[2020,10,7]]}}}