In this study, episodes of acute kidney injury (AKI) occurring during diabetic ketoacidosis (DKA) in children with type 1 diabetes were found to be significantly linked with risk of developing microalbuminuria. There is a need for greater efforts to attenuate the frequency of DKA.

• In this case-control study of 2,345 children with type 1 diabetes, researchers sought to determine if episodes of AKI occurring during DKA were linked with elevated risk of development of microalbuminuria.

• Each episode of AKI during DKA was identified to be linked with a hazard ratio of 1.56 for development of microalbuminuria, as revealed 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 occurred in association with four or more episodes.

• DKA episodes without AKI did not significantly elevate the hazard rate for microalbuminuria occurrence post-adjusting for other covariates.