MON-645 - Comparison of Micro and Macrovascular Complication Prevalence and Cognition in Type 1 Diabetes Children with or without Acute Kidney Injury and Diabetic Ketoacidosis.

Background: Acute kidney injury (AKI) is increasingly recognised during diabetic ketoacidosis (DKA) in children with Type 1 diabetes mellitus (T1DM). Its long-term impact on vascular and cognitive outcomes remains unclear.

Aim: To compare, in a case–control design, the prevalence of microvascular and macrovascular complications and cognitive outcomes in children with T1DM who developed AKI during DKA with those who had DKA without AKI.

Methods: This case–control study was conducted at a tertiary centre in northern India and included 100 children aged 2–18 years with T1DM. Fifty children with documented AKI during DKA (KDIGO criteria) and at least one year of follow-up were enrolled as cases; 50 age- and sex-matched children with DKA but no AKI served as controls. Clinical details, metabolic control, and laboratory parameters were collected. Microvascular outcomes (microalbuminuria, neuropathy, retinopathy), macrovascular markers (blood pressure, lipid profile), and cognitive function (MISIC or DP-3) were assessed. Statistical comparisons used t-tests, Mann–Whitney U, and chi-square tests.

Results: Baseline characteristics were similar across groups. Glycaemic control was marginally poorer in the AKI group. Microalbuminuria (21% vs. 9%) and dyslipidemia (57.1% vs. 42.9%) were more frequent in cases, though not statistically significant. Hypertension, eGFR, and mean IQ scores were comparable, but a higher proportion of AKI cases had below-average IQ. Subgroup analyses showed trends toward higher complication rates with poorer glycaemic control and greater AKI severity.

Conclusion: Children with T1DM who experienced AKI during DKA had higher—but non-significant—rates of microvascular abnormalities, dyslipidemia, and lower cognitive scores. Although limited by sample size and follow-up duration, these trends highlight the need for larger, long-term studies to define the impact of AKI on vascular and neurocognitive outcomes.

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