Eun Mi Yang1, Kee Hwan Yoo2, Yo Han Ahn3, Seong Heon Kim4, Jung Won Lee5, Woo Yeong Chung6, Min Hyun Cho7, Kee Hyuck Kim8, Heeyeon Cho9, Mee Jeong Lee10, Jin-Soon Suh11, Hye Sun Hyun12, Jiwon M Lee13, Myung Hyun Cho14, Ji Hyun Kim15, Il-Soo Ha3,16, Hae Il Cheong3, Hee Gyung Kang17,18,19. 1. Department of Pediatrics, Chonnam National University Hospital, Gwangju, South Korea. 2. Korea University Guro Hospital, Seoul, South Korea. 3. Seoul National University Children's Hospital and Seoul National University College of Medicine, 101 Daehak-ro, Jongno-Gu, Seoul, 03080, South Korea. 4. Pusan National University Children's Hospital, Yangsan, South Korea. 5. Ewha Womans University, College of Medicine, Seoul, South Korea. 6. Busan Paik Hospital, Inje University, Busan, South Korea. 7. Kyungpook National University, School of Medicine, Daegu, South Korea. 8. NHIC Ilsan Hospital, Goyang, South Korea. 9. Sungkyunkwan University Samsung Medical Center, Seoul, South Korea. 10. Dankook University College of Medicine, Cheonan, South Korea. 11. Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea. 12. St. Vincent's Hospital, College of Medicine, The Catholic University, Suwan, South Korea. 13. Chungnam National University Hospital, Daejeon, South Korea. 14. Hallym University Sacred Heart Hospital, Anyang, South Korea. 15. Seoul National University Bundang Hospital, Seongnam, South Korea. 16. Kidney Research Institute, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea. 17. Seoul National University Children's Hospital and Seoul National University College of Medicine, 101 Daehak-ro, Jongno-Gu, Seoul, 03080, South Korea. kanghg@snu.ac.kr. 18. Kidney Research Institute, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea. kanghg@snu.ac.kr. 19. Wide River Institute of Immunology, Seoul National University, Hongcheon, South Korea. kanghg@snu.ac.kr.
Abstract
BACKGROUND: Children with nephrotic syndrome (NS) are at an increased risk of acute kidney injury (AKI) and the incidence of AKI in this population is reportedly increasing. This study aimed to investigate the incidence, clinical profiles, and risk factors of AKI in hospitalized children with NS through a nationwide study. METHODS: This retrospective multicenter study included 14 pediatric nephrology centers in Korea. From 2013 to 2017, a total of 814 patients with idiopathic NS were cared for at participating centers. Among them, 363 patients were hospitalized for NS and investigated in this study. RESULTS: A total of 363 children with NS were hospitalized 574 times. AKI occurred in 93 admissions (16.2%) of 89 patients: 30 (32.3%) stage 1; 24 (25.8%) stage 2; and 39 (41.9%) stage 3. Multivariate logistic regression analysis showed that longer disease duration, lower albumin level, and methylprednisolone pulse treatment were significantly associated with AKI development in hospitalized children with NS. AKI was associated with a longer hospital stay than non-AKI (median 10 vs. 7 days, P = 0.001). Among 93 admissions, 85 (91.4%) episodes recovered from AKI without complication, whereas 6 (6.5%) progressed to advanced chronic kidney disease (CKD). CONCLUSIONS: AKI is not uncommon in hospitalized children with NS, and its incidence in this nationwide study was 16.2%. Risk factors for AKI in hospitalized children with NS include longer disease duration, lower albumin level, and methylprednisolone pulse therapy. Pediatric NS patients with these characteristics should be under more strict scrutiny for the occurrence of AKI. Graphical abstract.
BACKGROUND: Children with nephrotic syndrome (NS) are at an increased risk of acute kidney injury (AKI) and the incidence of AKI in this population is reportedly increasing. This study aimed to investigate the incidence, clinical profiles, and risk factors of AKI in hospitalized children with NS through a nationwide study. METHODS: This retrospective multicenter study included 14 pediatric nephrology centers in Korea. From 2013 to 2017, a total of 814 patients with idiopathic NS were cared for at participating centers. Among them, 363 patients were hospitalized for NS and investigated in this study. RESULTS: A total of 363 children with NS were hospitalized 574 times. AKI occurred in 93 admissions (16.2%) of 89 patients: 30 (32.3%) stage 1; 24 (25.8%) stage 2; and 39 (41.9%) stage 3. Multivariate logistic regression analysis showed that longer disease duration, lower albumin level, and methylprednisolone pulse treatment were significantly associated with AKI development in hospitalized children with NS. AKI was associated with a longer hospital stay than non-AKI (median 10 vs. 7 days, P = 0.001). Among 93 admissions, 85 (91.4%) episodes recovered from AKI without complication, whereas 6 (6.5%) progressed to advanced chronic kidney disease (CKD). CONCLUSIONS: AKI is not uncommon in hospitalized children with NS, and its incidence in this nationwide study was 16.2%. Risk factors for AKI in hospitalized children with NS include longer disease duration, lower albumin level, and methylprednisolone pulse therapy. Pediatric NS patients with these characteristics should be under more strict scrutiny for the occurrence of AKI. Graphical abstract.
Authors: Michelle N Rheault; Chang-Ching Wei; David S Hains; Wei Wang; Bryce A Kerlin; William E Smoyer Journal: Pediatr Nephrol Date: 2013-09-14 Impact factor: 3.714
Authors: Scott M Sutherland; John J Byrnes; Manish Kothari; Christopher A Longhurst; Sanjeev Dutta; Pablo Garcia; Stuart L Goldstein Journal: Clin J Am Soc Nephrol Date: 2015-02-03 Impact factor: 8.237
Authors: Michelle N Rheault; Lei Zhang; David T Selewski; Mahmoud Kallash; Cheryl L Tran; Meredith Seamon; Chryso Katsoufis; Isa Ashoor; Joel Hernandez; Katarina Supe-Markovina; Cynthia D'Alessandri-Silva; Nilka DeJesus-Gonzalez; Tetyana L Vasylyeva; Cassandra Formeck; Christopher Woll; Rasheed Gbadegesin; Pavel Geier; Prasad Devarajan; Shannon L Carpenter; Bryce A Kerlin; William E Smoyer Journal: Clin J Am Soc Nephrol Date: 2015-10-08 Impact factor: 8.237