Acidosis at Diagnosis of Type 1 Diabetes Mellitus: Relation With Kidney Function
Authors' conclusion
A link exists between biological markers of RTD and metabolic acidosis at T1DM onset.
Study context
- Population
- Individuals at T1D onset; Renal tubular damage (RTD) defined by urinary β2-microglobulin > 0.33 mg/L and/or neutrophil gelatinase-associated lipocalin (NGAL) > 95th percentile for age
- Participants
- 185 individuals
- Exposure
- Groups by serum ketone and bicarbonate levels
- Group 1n = 111
- Group 2n = 18
- Group 3n = 8
- Group 4n = 48
- Outcome
- Factors associated with acidosis groups (logistic regression adjusted for acute kidney injury (AKI), relative weight loss and HbA1c)
- Follow-up
- T1D onset
Main finding
As reported in the abstract
RTD associated with Group 1, OR (95% CI); p
22.3
6.9–71.5p < 0.001
Relative difference of weight loss associated with Group 1, OR (95% CI); p
1.2
1.1–1.4p < 0.006
Only RTD associated with Group 2, OR (95% CI); p
29.9
3.0–292.9p=0.004
Observational data: associations, not effects.
Further findings
Clinical and biochemical derangements
- Group 1 had the most severe derangements, followed by Groups 2, 3 and 4
Correlation of serum bicarbonate and blood pH with urinary markers
- Inverse correlation with urinary NGAL, r 2 (bicarbonate; pH)
- 0.61; 0.56, both p < 0.001
- Inverse correlation with β2-microglobulin, r 2 (bicarbonate; pH)
- 0.67; 0.59, both p < 0.001
- Regardless of ketone levels
Prediction of renal tubular status
- Ketone-to-bicarbonate ratio predicting RTD, AUROC (95% CI); p
- 0.94 (0.91-0.97); p < 0.001
- Serum bicarbonate predicting normal renal tubular function, AUROC (95% CI); p
- 0.95 (0.92-0.98); p < 0.001
Original publication
Acidosis at Diagnosis of Type 1 Diabetes Mellitus: Relation With Kidney Function. Pediatr Diabetes. Published 17 November 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →