Acute kidney injury in children with moderate-severe COVID-19 and multisystem inflammatory syndrome in children: a referral center experience.
Background: Data on the characteristics of acute kidney injury (AKI) in pediatric COVID-19 and MIS-C are limited. We aimed to define the frequency, associated factors and early outcome of AKI in moderate, severe or critical COVID-19 and MIS-C; and to present a tertiary referral center experience fro...
| Publicado en: | Pediatric Nephrology Vol. 39; no. 3; pp. 867 - 878 |
|---|---|
| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Mar2024
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=175022067&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 175022067 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Mar2024 vid: 39 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 175022067 171795501 175022067 175022067 10.1007/s00467-023-06125-3 175022067 ppf: 867 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Acute kidney injury in children with moderate-severe COVID-19 and multisystem inflammatory syndrome in children: a referral center experience. aug: au: Tastemel Ozturk, Tugba Düzova, Ali Oygar, Pembe Derin Baltu, Demet Ozcilingir Hakverdi, Pelin Lacinel Gurlevik, Sibel Kurt-Sukur, Eda Didem Aykan, Hayrettin Hakan Ozen, Seza Ertugrul, Ilker Kesici, Selman Gulhan, Bora Ozaltin, Fatih Ozsurekci, Yasemin Cengiz, Ali Bulent Topaloglu, Rezan affil: https://ror.org/04kwvgz42 Division of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye sug: subj: COVID-19 Complications Severity of Illness Adverse Effects Multisystem Inflammatory Syndrome Complications Kidney Failure, Acute Risk Factors Risk Assessment Tertiary Health Care Turkiye Disease Attributes Pediatric Care Human Male Female Turkiye Adolescence Infant, Newborn Infant Child, Preschool Child Hospitals, Pediatric Hospitalization Descriptive Statistics Comparative Studies Multivariate Analysis Odds Ratio Length of Stay COVID-19 Mortality Vasoconstrictor Agents Lymphocyte Count Cardiotonic Agents Inflammation Cardiovascular Diseases Adolescent: 13-18 years Infant, Newborn: birth-1 month Infant: 1-23 months Child, Preschool: 2-5 years Child: 6-12 years Male Female ab: Background: Data on the characteristics of acute kidney injury (AKI) in pediatric COVID-19 and MIS-C are limited. We aimed to define the frequency, associated factors and early outcome of AKI in moderate, severe or critical COVID-19 and MIS-C; and to present a tertiary referral center experience from Türkiye. Methods: Hospitalized patients ≤ 18 years of age with confirmed COVID-19 or MIS-C at İhsan Doğramacı Children's Hospital, Hacettepe University, between March 2020—December 2021 were enrolled. The characteristics of AKI in the COVID-19 group were investigated in moderate, severe and critically ill patients; patients with mild COVID-19 were excluded. Results: The median (Q1-Q3) age in the COVID-19 (n = 66) and MIS-C (n = 111) groups was 10.7 years (3.9–15.2) and 8.7 years (4.5–12.7), respectively. The frequency of AKI was 22.7% (15/66) in COVID-19 and 15.3% (17/111) in MIS-C; all MIS-C patients with AKI and 73.3% (11/15) of COVID-19 patients with AKI had AKI at the time of admission. Multivariate analyses revealed need for vasoactive/inotropic agents [Odds ratio (OR) 19.233, p = 0.002] and presence of vomiting and/or diarrhea (OR 4.465, p = 0.036) as independent risk factors of AKI in COVID-19 patients; and need for vasoactive/inotropic agents (OR 22.542, p = 0.020), procalcitonin and ferritin levels as independent risk factors of AKI in the MIS-C group. Age was correlated with lymphocyte count (r = -0.513, p < 0.001) and troponin level (r = 0.518, p < 0.001) in MIS-C patients. Length of hospital stay was significantly longer in both groups with AKI, compared to those without AKI. Mortality was 9.1% in the COVID-19 group; and was associated with AKI (p = 0.021). There was no mortality in MIS-C patients. AKI recovery at discharge was 63.6% in COVID-19 survivors and 100% in MIS-C patients. Conclusions: Independent risk factors for AKI were need for vasoactive/inotropic agents and vomiting/diarrhea in moderate, severe or critical COVID-19 patients; and need for vasoactive/inotropic agents and severe inflammation in MIS-C patients. Our findings suggest that inflammation and cardiac dysfunction are associated with AKI in MIS-C patients; and the association with age in this group merits further studies in larger groups. Early outcome is favorable; long-term follow-up for kidney functions is needed. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|