Huang JX, Casper TC, Pitts C, et al. - Among children with type 1 diabetes who were analyzed in this study, a significant association was found between episodes of acute kidney injury (AKI) occurring during diabetic ketoacidosis (DKA) and the risk of developing microalbuminuria. To attenuate DKA frequency, greater efforts are required.

• In this retrospective review, 2345 children with type 1 diabetes (mean (SD) age at diagnosis was 9.4 (4.4) years) were analyzed.

• In 41% of the participants, one or more episodes of DKA occurred, and AKI developed during DKA in 560 episodes (47%).

• Each episode of AKI during DKA was found to be related to a hazard ratio of 1.56 for occurrence of microalbuminuria, in multivariable models adjusting for the links of age at diagnosis and mean hemoglobin A _1c level since diagnosis.

• An increase in the hazard rate by more than 5-fold was seen with four or more episodes.