Document Type : original article
Authors
1 Assistant Professor, Department of pediatric nephrology, Faculty of Medicine, Sabzevar University of Medical Sciences, Khorasan Razavi, Iran
2 Assistant Professor, Department of Community Medicine, Faculty of Medicine, Sabzevar University of Medical Sciences, Khorasan Razavi, Iran
3 Department of Pediatric Nephrology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
4 General Practitioner, Zahedan University of Medical Sciences, Zahedan, Iran
5 Department of Pediatric Medicine, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
Abstract
Objective: Diabetic Ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus, particularly prevalent in pediatric populations. This review aims to explore the correlation between blood gas parameters, serum blood urea nitrogen (BUN)/creatinine (Cr) ratio, and estimated glomerular filtration rate (eGFR) in pediatric patients aged 2 to 18 years hospitalized with DKA at Heshmatieh Hospital in Sabzevar between 2016 and 2022.
Study design: In this retrospective study, 84 patients diagnosed with diabetic ketoacidosis (DKA) were included. Arterial blood gas analysis was performed to assess pH, bicarbonate (HCO₃⁻), and anion gap levels, which are key parameters for evaluating DKA severity and guiding clinical management. Renal function was evaluated using the blood urea nitrogen-to-creatinine ratio (BUN/Cr) and estimated glomerular filtration rate (eGFR), as dehydration and metabolic disturbances during DKA may acutely impair kidney function. These laboratory markers were analyzed to explore their utility in monitoring both metabolic and renal status throughout the treatment course.
Results: This study evaluates the interplay between these parameters to identify potential biomarkers for assessing DKA severity and predicting clinical outcomes. Preliminary findings suggest that abnormal blood gas values, elevated BUN/Cr ratios, and reduced eGFR levels are associated with more severe DKA presentations and prolonged hospital stays. The integration of these biomarkers into clinical practice may enhance early risk stratification, optimize fluid and electrolyte management, and improve overall patient outcomes.
Conclusions: This review underscores the importance of a multidisciplinary approach in managing pediatric DKA, emphasizing the role of laboratory parameters in guiding timely and effective interventions. Further research is warranted to validate these correlations and establish standardized protocols for their application in clinical settings.
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