Jameela Abdulaziz Kari1, Mohamed A Shalaby2, Amr S Albanna3, Turki S Alahmadi4, Adi Alherbish5, Khalid A Alhasan5. 1. Pediatric Nephrology Center of Excellence, Department of Pediatrics, King Abdulaziz University, PO Box: 80215, 21589, Jeddah, Kingdom of Saudi Arabia. jkari@doctors.org.uk. 2. Pediatric Nephrology Center of Excellence, Department of Pediatrics, King Abdulaziz University, PO Box: 80215, 21589, Jeddah, Kingdom of Saudi Arabia. 3. King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Kingdom of Saudi Arabia. 4. Department of Pediatrics, King Abdulaziz University and Faculty of Medicine in Rabigh, Jeddah, Kingdom of Saudi Arabia. 5. Pediatrics Department, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Abstract
BACKGROUND: Acute kidney injury (AKI) is a complication of coronavirus disease 2019 (COVID-19). The reported incidence of AKI, however, varies among studies. We aimed to evaluate the incidence of AKI and its association with mortality and morbidity in children infected with severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) who required hospital admission. METHODS: This was a multicenter retrospective cohort study from three tertiary centers, which included children with confirmed COVID-19. All children were evaluated for AKI using the Kidney Disease Improving Global Outcomes (KDIGO) definition and staging. RESULTS: Of 89 children included, 19 (21 %) developed AKI (52.6 % stage I). A high renal angina index score was correlated with severity of AKI. Also, multisystem inflammatory syndrome in children (MIS-C) was increased in children with AKI compared to those with normal kidney function (15 % vs. 1.5 %). Patients with AKI had significantly more pediatric intensive care admissions (PICU) (32 % vs. 2.8 %, p < 0.001) and mortality (42 % vs. 0 %, p < 0.001). However, AKI was not associated with prolonged hospitalization (58 % vs. 40 %, p = 0.163) or development of MIS-C (10.5 % vs. 1.4 %, p = 0.051). No patient in the AKI group required renal replacement therapy. Residual renal impairment at discharge occurred in 9 % of patients. This was significantly influenced by the presence of comorbidities, hypotension, hypoxia, heart failure, acute respiratory distress, hypernatremia, abnormal liver profile, high C-reactive protein, and positive blood culture. CONCLUSIONS: AKI occurred in one-fifth of children with SARS-CoV-2 infection requiring hospital admission, with one-third of those requiring PICU. AKI was associated with increased morbidity and mortality, and residual renal impairment at time of discharge.
BACKGROUND:Acute kidney injury (AKI) is a complication of coronavirus disease 2019 (COVID-19). The reported incidence of AKI, however, varies among studies. We aimed to evaluate the incidence of AKI and its association with mortality and morbidity in childreninfected with severe acute respiratory distress syndromecoronavirus 2 (SARS-CoV-2) who required hospital admission. METHODS: This was a multicenter retrospective cohort study from three tertiary centers, which included children with confirmed COVID-19. All children were evaluated for AKI using the Kidney Disease Improving Global Outcomes (KDIGO) definition and staging. RESULTS: Of 89 children included, 19 (21 %) developed AKI (52.6 % stage I). A high renal angina index score was correlated with severity of AKI. Also, multisystem inflammatory syndrome in children (MIS-C) was increased in children with AKI compared to those with normal kidney function (15 % vs. 1.5 %). Patients with AKI had significantly more pediatric intensive care admissions (PICU) (32 % vs. 2.8 %, p < 0.001) and mortality (42 % vs. 0 %, p < 0.001). However, AKI was not associated with prolonged hospitalization (58 % vs. 40 %, p = 0.163) or development of MIS-C (10.5 % vs. 1.4 %, p = 0.051). No patient in the AKI group required renal replacement therapy. Residual renal impairment at discharge occurred in 9 % of patients. This was significantly influenced by the presence of comorbidities, hypotension, hypoxia, heart failure, acute respiratory distress, hypernatremia, abnormal liver profile, high C-reactive protein, and positive blood culture. CONCLUSIONS: AKI occurred in one-fifth of children with SARS-CoV-2 infection requiring hospital admission, with one-third of those requiring PICU. AKI was associated with increased morbidity and mortality, and residual renal impairment at time of discharge.
Entities:
Keywords:
Acute Kidney Injury; COVID-19; Child; Multisystem Inflammatory Syndrome in Children
Authors: Abby Basalely; Shari Gurusinghe; James Schneider; Sareen S Shah; Linda B Siegel; Gabrielle Pollack; Pamela Singer; Laura J Castellanos-Reyes; Steven Fishbane; Kenar D Jhaveri; Elizabeth Mitchell; Kumail Merchant; Christine Capone; Ashley M Gefen; Julie Steinberg; Christine B Sethna Journal: Kidney Int Date: 2021-03-03 Impact factor: 10.612
Authors: Houda Nassih; Sara Belghmaidi; Rabiy El Qadiry; Ibtissam Hajji; Aicha Bourrahouat; Abdeljalil Moutaouakil; Imane Ait Sab Journal: Glob Pediatr Health Date: 2022-07-22
Authors: Duvuru Geetha; Andreas Kronbichler; Megan Rutter; Divya Bajpai; Steven Menez; Annemarie Weissenbacher; Shuchi Anand; Eugene Lin; Nicholas Carlson; Stephen Sozio; Kevin Fowler; Ray Bignall; Kathryn Ducharlet; Elliot K Tannor; Eranga Wijewickrama; Muhammad I A Hafidz; Vladimir Tesar; Robert Hoover; Deidra Crews; Charles Varnell; Lara Danziger-Isakov; Vivekanand Jha; Sumit Mohan; Chirag Parikh; Valerie Luyckx Journal: Nat Rev Nephrol Date: 2022-08-24 Impact factor: 42.439