Reversible tubular proteinuria associated with hyperglycemic ketoacidosis in type 1 diabetes mellitus.

Urinary protein excretion has been investigated in 14 children with hyperglycemic ketoacidosis secondary to diabetes mellitus. In 9 patients hyperglycemic ketoacidosis was the first manifestation of their disease and 5 patients were known diabetics and accidentally developed hyperglycemic ketoacidosis. A control group consisted of 15 diabetic children aged 7-16 years with good metabolic control. Duration of the disease ranged from 1 month to 9 years. A second group of controls consisted of 24 healty children aged 10-16 years. Urinary protein fractions were separated by sodium dodecyl sulphate polyacrylamide gel electrophoresis. Tubular proteinuria was found in all diabetic patients during hyperglycemic ketoacidosis and disappeared in all cases within 4 weeks of establishing satisfactory diabetic control. The pathological basis and effect of transient tubulointerstitial insufficiency as indicated by transient tubular proteinuria is discussed.