PT - JOURNAL ARTICLE AU - Ravi Varma AU - Mahzuz Karim TI - Lesson of the month 1: Diabetic ketoacidosis in established renal failure AID - 10.7861/clinmedicine.16-4-392 DP - 2016 Aug 01 TA - Clinical Medicine PG - 392--393 VI - 16 IP - 4 4099 - http://www.rcpjournals.org/content/16/4/392.short 4100 - http://www.rcpjournals.org/content/16/4/392.full SO - Clin Med2016 Aug 01; 16 AB - Diabetic ketoacidosis (DKA) is a common medical emergency. The pathophysiology of DKA in patients with advanced chronic kidney disease differs significantly from patients with preserved renal function. We describe a patient with pre-dialysis renal failure who presented with DKA. This case highlights the importance of tailoring the established management guidelines appropriately.