Renal Resistivity Index in Pediatrics with Diabetic Ketoacidosis

Background Diabetic ketoacidosis (DKA) is one of the main causes of end-stage kidney disease (ESKD). Renal resistivity index is a well-known indicator of renal tubulopathy. Objectives To determine the renal resistivity index by duplex ultrasound in children and adolescents with type 1 diabetes mellitus (T1DM) during DKA. Patients and Methods A prospective longitudinal study was conducted over 1 year, where we have included children aged between 6-18 years with T1DM presented to Emergency Room (ER) &Pediatric and Adolescents Diabetes Unit Children Hospital, Faculty of Medicine, Ain Shams University, with moderate and severe DKA and complete clinical and laboratory data about renal function prior to the study was done, we have excluded from our study children with comorbid disorders affecting renal function or any chronic kidney disorders, and renal resistivity index was assessed by using duplex ultra sound scanning. Results During the study period, a total of 40 pediatric patients were included with T1DM with, with a female predominance (90%).The mean (±SD) age at presentation was 10.59±2.17 years.According to eGFR, children with T1DM presented with moderate and severe DKA at presentation were classified as those with proteinuria (18 patients)45% and those without protienuria (22 patients)55% (p < 0.001) .Furthermore children with protienuria had a significantly elevated renal resistivity index of the right kidney with mean (0.64±0.09) and that of the left kidney was (0.57±0.05), with P-value (p < 0.05). Conclusion The renal resistivity index is a good indicator of renal tubulopathy in children and adolescent with DKA at the time of presentation.