The relationship between hyperchloremia and acute kidney injury in pediatric diabetic ketoacidosis and its impact on clinical outcomes

Ahmed, Heba Mostafa; Elnaby, Hagar Ramadan Hasb; Kareem, Rehab Muhammad Abd El; Hodeib, Mahmoud

doi:10.1007/s00467-021-05279-2

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…In line with these findings, Baalaaji et al reported that serum chloride >112 mmol/L at 24 h after hospital admission was significantly associated with AKI progression 11 . Several other studies reported that hyperchloremia was associated with AKI in critically ill children 31–33 . Hyperchloremia had a renal vascular smooth muscle constrictor effect 34 and could reduce renal blood flow and glomerular filtration rate and consequently cause AKI 35 …”

Section: Discussionmentioning

confidence: 85%

Incidence and factors associated with acute kidney injury among children with type 1 diabetes hospitalized with diabetic ketoacidosis: A prospective study

2022

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Section: Discussionmentioning

confidence: 85%

Incidence and factors associated with acute kidney injury among children with type 1 diabetes hospitalized with diabetic ketoacidosis: A prospective study

2022

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“…It can lead to renal vasoconstriction, decreased glomerular filtration rate, and impaired renal function. In similar vein, hyperchloremia can also impact cardiac contractility, promote systemic inflammation, and potentially prolong the duration of DKA [23], [26]- [28].…”

mentioning

confidence: 99%

“…Several authors have explored the prevalence of hyperchloremia in DKA management and have explored different modeling techniques to predict its likelihood. Some of these methods used a variety of models ranging from statistical models [28]- [30] and artificial intelligence and machine learning techniques [31]- [34]. Statistical models use observed data and assumptions for estimating and analyzing relationships, making predictions, and drawing inferences about a phenomenon of interest.…”

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confidence: 99%

An Improved Ensemble Method for Predicting Hyperchloremia in Adults With Diabetic Ketoacidosis

Obaido,

Ogbuokiri,

Chukwu

et al. 2024

IEEE Access

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Diabetic ketoacidosis (DKA) is a serious complication that affects millions of individuals globally and presents significant health complications. Hyperchloremia, an electrolyte imbalance characterized by high levels of chloride in the blood, may result in gastrointestinal problems, kidney damage, and even death, especially in DKA patients. Early detection and treatment of hyperchloremia are of utmost importance in the management of DKA. This study explores the potential of the bootstrap aggregating ensemble with random subspaces machine learning approach to predict the occurrence of hyperchloremia, providing a basis for early intervention and improved patient outcomes. We tested our approach with the retrospective MIMIC-III database containing 1177 DKA patients and compared it with previous studies with an area under the curve (AUC) of 100%. Our approach showed significant performance outperforming other methods. The combination of this approach may enhance the early detection and timely intervention for hyperchloremia cases, ultimately leading to improved patient outcomes and a more effective management of DKA-associated complications. Our work aims to contribute to the development of decision support tools for healthcare professionals, assisting them in making informed decisions for DKA patients, with a focus on preventing and managing hyperchloremia. INDEX TERMS Boosting Aggregating or Bagging Classifier, Diabetic Ketoacidosis (DKA), Hyperchloremia, Machine Learning, Predictive Modelling I. INTRODUCTIONDiabetes, a metabolic disorder, disrupts the regulation of blood glucose levels which can lead to both short-term and long-term health complications, and in severe cases, even death if not effectively managed [1]-[5]. This condition is broadly categorized into two types: type 1 diabetes (TY1D) and type 2 diabetes (TY2D). The pancreas plays a vital role in producing insulin, and serves as a key regulator for blood sugar levels. Insulin acts as a major energy source for muscles and various tissues, facilitating the entry of blood sugar into the body's cells [6]. This process is particularly significant in understanding both TY1D and TY2D as disruptions in insulin production or its effectiveness can lead to distinct metabolic imbalances and complications associated with each type. Both TY1D and TY2D diabetes are chronic diseases that affect millions of people worldwide

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“…No nosso estudo, entretanto, não foi o foco o seguimento dos pacientes para avaliação posterior da sustentação de lesão renal por meio da presença de microalbuminúria. Essa análise pode ser retomada em momento posterior.Outros estudos publicados com enfoque na IRA em pacientes pediátricos com CAD trazem achados semelhantes em relação à prevalência de IRA, fatores de risco para seu desenvolvimento, comportamento dos achados clínicos e laboratoriais aos já discutidos em diferentes populações: Arábia Saudita, Canadá, Coréia do Sul, Egito, Estados Unidos, Índia, Israel, Polônia[64][65][66]68,69,[71][72][73][74][75][76][77][78][79] . Porém, o nosso é o primeiro no Brasil e com protocolo de tratamento distinto.…”

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Avaliação da injúria renal aguda e de parâmetros bioquímicos em crianças e adolescentes com cetoacidose diabetica tratados com fluidoterapia inicial mais agressiva

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The relationship between hyperchloremia and acute kidney injury in pediatric diabetic ketoacidosis and its impact on clinical outcomes

Cited by 7 publications

References 22 publications

Incidence and factors associated with acute kidney injury among children with type 1 diabetes hospitalized with diabetic ketoacidosis: A prospective study

Incidence and factors associated with acute kidney injury among children with type 1 diabetes hospitalized with diabetic ketoacidosis: A prospective study

An Improved Ensemble Method for Predicting Hyperchloremia in Adults With Diabetic Ketoacidosis

Avaliação da injúria renal aguda e de parâmetros bioquímicos em crianças e adolescentes com cetoacidose diabetica tratados com fluidoterapia inicial mais agressiva

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