Background: Sepsis-associated acute kidney injury (SA-AKI) is a serious complication affecting roughly 24% of critically ill pediatric patients. Yet, data is limited regarding SA-AKI in pediatric type 1 diabetes mellitus (T1DM). This study’s aim was to provide pilot data for future prospective research on SA-AKI in children with or without T1DM. Subjects and Methods: Retrospective pilot study included 30 pediatric intensive care unit patients – one infant, 19 children (>1–12 years), and 10 adolescents (13–18 years). Consistent with the prevailing diagnostic criteria utilized at the time of admission (2015–2020), sepsis was defined according to the 2005 International Pediatric Sepsis Consensus Conference criteria, as Systemic Inflammatory Response Syndrome plus suspected or confirmed infection. Analyses were conducted in jamovi (v2.6.26). Results: Critically ill T1DM patients were statistically significantly more likely to experience SA-AKI ( P < 0.001). 84.61% of T1DM patients ( n = 13) developed SA-AKI, with higher mean glucose levels on admission across bacterial, viral, and culture-negative endotypes as compared to T1DM patients without SA-AKI. Vancomycin use associated with SA-AKI was not statistically significant, though all T1DM patients who received vancomycin ( n = 4) developed SA-AKI. There was no significant difference among blood urea nitrogen (BUN), creatinine (Cr), BUN to Cr ratios, and baseline to admission Cr ratios in T1DM versus non-T1DM children and adolescents. However, higher mean values were observed in T1DM children than in adolescents. Conclusions: Results may provide preliminary evidence that T1DM confers increased susceptibility to SA-AKI. Additional studies are needed to determine if such mechanisms exist and promote interventions to prevent SA-AKI in critically ill pediatric T1DM patients.
Gremillion et al. (Thu,) studied this question.