Al-Matrafi Jamila, Vethamuthu Jennifer, Feber Janusz
Department of Pediatrics, Division of Nephrology, Children's Hospital of Eastern Ontario, Ottawa, Canada.
Saudi J Kidney Dis Transpl. 2009 Sep;20(5):831-4.
Acute renal failure (ARF) is a rare but potentially fatal complication of diabetic ketoacidosis (DKA). Early recognition and aggressive treatment of ARF during DKA may im-prove the prognosis of these patients. We present a case report of a 12 year old female admitted to the hospital with severe DKA as the 1s t manifestation of her diabetes mellitus. She presented with severe metabolic acidosis, hypophosphatemia, and oliguric ARF. In addition, rhabdomyolysis was noted during the course of DKA which probably contributed to the ARF. Management of DKA and renal replacement therapy resulted in quick recovery of renal function. We suggest that early initiation of renal replacement therapy for patients with DKA developing ARF may improve the potentially poor outcome of patients with ARF associated with DKA.
急性肾衰竭（ARF）是糖尿病酮症酸中毒（DKA）一种罕见但可能致命的并发症。在DKA期间对ARF进行早期识别和积极治疗可能会改善这些患者的预后。我们报告一例12岁女性患者，以严重DKA作为其糖尿病的首发表现入院。她表现为严重代谢性酸中毒、低磷血症和少尿性ARF。此外，在DKA病程中发现横纹肌溶解，这可能是导致ARF的原因。DKA的治疗和肾脏替代治疗使肾功能迅速恢复。我们建议，对于发生ARF的DKA患者早期开始肾脏替代治疗可能会改善与DKA相关的ARF患者潜在的不良预后。
