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Acute kidney injury in children with COVID-19: a retrospective study.
Kari, Jameela Abdulaziz; Shalaby, Mohamed A; Albanna, Amr S; Alahmadi, Turki S; Alherbish, Adi; Alhasan, Khalid A.
  • Kari JA; Pediatric Nephrology Center of Excellence, Department of Pediatrics, King Abdulaziz University, PO Box: 80215, 21589, Jeddah, Kingdom of Saudi Arabia. jkari@doctors.org.uk.
  • Shalaby MA; Pediatric Nephrology Center of Excellence, Department of Pediatrics, King Abdulaziz University, PO Box: 80215, 21589, Jeddah, Kingdom of Saudi Arabia.
  • Albanna AS; King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Kingdom of Saudi Arabia.
  • Alahmadi TS; Department of Pediatrics, King Abdulaziz University and Faculty of Medicine in Rabigh, Jeddah, Kingdom of Saudi Arabia.
  • Alherbish A; Pediatrics Department, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
  • Alhasan KA; Pediatrics Department, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
BMC Nephrol ; 22(1): 202, 2021 05 31.
Article in English | MEDLINE | ID: covidwho-1249548
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Kidney Injury / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Child / Child, preschool / Female / Humans / Male Language: English Journal: BMC Nephrol Journal subject: Nephrology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Kidney Injury / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Child / Child, preschool / Female / Humans / Male Language: English Journal: BMC Nephrol Journal subject: Nephrology Year: 2021 Document Type: Article