Acute kidney injury at the onset of type 1 diabetes mellitus: a balance between kidney stress and nephron mass
Authors' conclusion
Our findings suggest a potential interplay between nephron mass and kidney stress in AKI development at T1DM onset. While uromodulin levels alone were not associated with AKI, a higher urinary uromodulin-to-NGAL ratio - possibly reflecting better-preserved nephron mass under stress - may be linked to a reduced risk of AKI. Further confirmation is needed.
Study context
- Population
- Children hospitalized for new-onset T1D; mean age 8.6 ± 4.3 years
- Participants
- 75 children
- Exposure
- Acute kidney injury (AKI) vs no AKI at T1D onset
- AKIn = 33
- Outcome
- Association of urinary uromodulin and uromodulin-to-NGAL ratio at T1D onset with AKI
- Follow-up
- T1D onset (admission)
Main finding
As reported in the abstract
Uromodulin-to-NGAL ratio vs highest-to-basal creatinine ratio, r
−0.42
p < 0.001
Neutrophil gelatinase-associated lipocalin (NGAL) vs highest-to-basal creatinine ratio, r
0.36
p = 0.001
AUC of urinary NGAL for predicting absence of AKI
0.66
95% CI 0.54–0.79p = 0.01
AUC of uromodulin-to-NGAL ratio for predicting absence of AKI
0.75
95% CI 0.63–0.86p < 0.001
Observational data: associations, not effects.
Further findings
DKA and AKI incidence · T1D onset
- DKA
- 33 (44%)
- DKA severity: severe / moderate / mild
- 11 / 10 / 12
- Developed AKI
- 33 (44%)
Original publication
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