Abstract
We undertook the present study to examine the acid-base and electrolyte disturbances in relation to hydration status in patients with diabetic ketoacidosis (DKA). A total of 40 insulin-dependent diabetes mellitus patients (22 male, 18 female), aged 18-61 years with DKA admitted to our hospital during the last 2 years, were studied. The duration of diabetes averaged 9 +/- 2 years. In all cases a detailed investigation of the acid-base status and electrolyte parameters was performed. Twenty-one patients had a pure metabolic acidosis with an increased serum anion gap, seven had DKA combined with hyperchloremic metabolic acidosis, nine had DKA coexisting with metabolic alkalosis, while three had DKA with a concurrent respiratory alkalosis. Hydration status as evidenced by the ratio of urea/creatinine seems to play an important role in the development of mixed acid-base disorders (detected by changes in the ratios delta anion gap/delta bicarbonate (delta AG/delta HCO3) and sodium/chloride (Na/Cl)). In fact, hyperchloremic acidosis developed in the patients with the better hydration status. However, contradictorily, the severely dehydrated patients who experienced recurrent episodes of vomiting developed DKA with a concurrent metabol...Continue Reading
References
Nov 1, 1975·Kidney International·S GarellaS I Kahn
Jan 1, 1977·Medicine·M Emmett, R G Narins
Jan 1, 1990·Nephron·M S OhJ Uribarri
Dec 1, 1986·The American Journal of Medicine·W D Paulson
Jul 1, 1972·The Journal of Clinical Investigation·F J GennariW B Schwartz
Feb 1, 1967·Annals of Internal Medicine·M S AlbertR W Winters
Jul 1, 1984·The American Journal of Medicine·J W CroninA R Rolla
Jan 1, 1984·American Journal of Nephrology·J R Oster, M Epstein
Apr 1, 1984·Kidney International·H J AdroguéW K Suki
Jul 1, 1984·Clinics in Endocrinology and Metabolism·D A GoodkinR G Narins
Dec 23, 1982·The New England Journal of Medicine·H J AdroguéG Eknoyan
Nov 1, 1993·The American Journal of the Medical Sciences·W D Paulson, M F Gadallah
Apr 1, 1986·The American Journal of Medicine·G T GamblinS C Beuttel
Citations
Sep 10, 2010·International Urology and Nephrology·Antonios H TzamaloukasGlen H Murata
Nov 30, 2000·Anesthesiology Clinics of North America·D S Prough
Mar 2, 2002·Anaesthesia·D G MaloneyR S Vaughan
Oct 24, 2008·Seminars in Dialysis·Antonios H TzamaloukasGlen H Murata
Dec 6, 2001·American Journal of Respiratory and Critical Care Medicine·J B BoordA C Powers
Jun 12, 2010·Diabetic Medicine : a Journal of the British Diabetic Association·A PapeJ R Flack
Jan 21, 2009·Basic & Clinical Pharmacology & Toxicology·Sari SoghoianRobert S Hoffman
Aug 6, 2015·The New England Journal of Medicine·Biff F Palmer, Deborah J Clegg
Aug 26, 1998·Lancet·S L Gluck
Nov 27, 2009·Diabetes Care·Keigo YasudaNoriyoshi Yamakita
Nov 17, 2016·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·Sachin ChaudharyAmit Kumar
Sep 11, 2004·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Pierre TabouletJean-Francois Gautier
Oct 4, 2018·BMJ Case Reports·Sushant NanavatiMonisha Singhal
Jan 17, 2019·PloS One·Tanja GärtnerKarsten Donat
Jul 28, 2007·Journal of the American Society of Nephrology : JASN·Asghar Rastegar
Aug 21, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Jeffrey A Kraut, Nicolaos E Madias
Oct 18, 2014·World Journal of Clinical Cases·George LiamisMoses Elisaf
May 23, 2007·Child Development·David B HenryJohn T Slavick
Nov 21, 1998·Critical Care Medicine·R F Reilly, R J Anderson
Sep 29, 2020·Frontiers in Medicine·Todd S IngAntonios H Tzamaloukas
Nov 29, 2012·Pediatric Emergency Care·Dai KimuraBalagangadhar R Totapally
Mar 15, 2005·Journal of Endocrinological Investigation·G KalambokisE V Tsianos
Apr 9, 2005·The International Journal of Artificial Organs·A H TzamaloukasC T Spalding
Mar 12, 2021·Diabetes & Metabolic Syndrome·Atif UsmanSiew Hua Gan
May 3, 2021·International Journal of Clinical Practice·Atif UsmanSiew Hua Gan
Jan 15, 2008·Journal of Diabetes and Its Complications·Antonios H TzamaloukasGlen H Murata
Nov 6, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Heba Mostafa AhmedMahmoud Hodeib