Severe Rhabdomyolysis and Acute Renal Failure Treated by Continuous Venovenous Hemodiafiltration in a Child with Diabetic Ketoacidosis

Abstract

Diabetic ketoacidosis (DKA) is the most serious hyperglycemic emergency in patients with type I diabetes mellitus and is associated with significant morbidity and mortality. DKA may be a life-threatening condition due to severe clinical and biological impairments and treatment-associated complications [cerebral edema, acute respiratory failure, acute renal failure (ARF), hypokalemia, hypophosphatemia]. The development of ARF with rhabdomyolysis is a rare but potentially lethal disorder in children with DKA with an estimated mortality of about 50%. Continuous renal replacement therapy is commonly used in intensive care units to provide renal replacement and fluid management. We successfully treated a 13-year-old boy with continuous venovenous hemodiafiltration, who had been diagnosed with severe DKA, complicated with hypophosphatemia-induced acute respiratory failure, rhabdomyolysis and ARF, persistent acidosis, and coma.