Acute kidney injury in critically ill children with COVID-19 and MIS-C

• Published in: Pediatric nephrology (Berlin, West) Vol. 38; no. 10; pp. 3475 - 3482
• Main Authors: Özen, Hasan, Aslan, Ayşen Durak, Balaban, Burak, Perk, Oktay, Uçmak, Hacer, Özcan, Serhan, Gurbanov, Anar, Uyar, Emel, Kahveci, Fevzi, Gün, Emrah, Tehci, Ali Kansu, Emeksiz, Serhat, Kendirli, Tanıl
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2023; Springer; Springer Nature B.V
• Subjects: Acute renal failure; Acute renal failure in children; Children; Confidence intervals; Coronaviruses; Cough; COVID-19; Diagnosis; Diseases; Hypotension; Inflammation; Intensive care units; Kidneys; Medicine; Medicine & Public Health; Nephrology; Original; Original Article; Patients; Pediatrics; Risk factors; Severe acute respiratory syndrome coronavirus 2; Urology; What’s new in AKI; Turkey; SARS-CoV-2; Pediatric intensive care; Multisystem inflammatory syndrome; Acute kidney injury
• ISSN: 0931-041X; 1432-198X
• DOI: 10.1007/s00467-023-05987-x

Background This study’s objective was to investigate the incidence of acute kidney injury (AKI) in children with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and multisystem inflammatory syndrome (MIS-C) and to report our clinical experience. Methods Acute COVID-19 and MIS-C-diagnosed patients observed in two pediatric intensive care units (PICUs) between 2019 and 2021 were examined for AKI and retrospectively compared to children with AKI. Results The study comprised 163 children, of whom 98 (60.1%) were diagnosed with acute COVID-19 and 65 (39.9%) with MIS-C. AKI was observed in 40 (40.8%) of the acute COVID-19 patients and 18 (27.7%) of the MIS-C patients. Low calcium level and hypotension were linked with AKI at initial presentation (OR: 0.56, 95% CI: 0.369–0.560, p = 0.006 and OR: 3.64, 95% CI: 1.885–7.152, p = 0.001, respectively). A history of nephrotoxic medication usage played an essential role in the development of AKI in patients who acquired AKI after hospitalization ( p = 0.001, odds ratio: 9.32, confidence interval: 3.106–27.973). In clinical practice, individuals with respiratory distress and cough had a high chance of having AKI (OR: 4.47, 95% confidence interval: 2.25–8,892 and OR: 3.48, 95% confidence interval: 1.76–6.88). AKI patients had a greater demand for respiratory assistance and a longer period of stay in the PICU. Conclusions AKI in the COVID-19 and MIS-C patient groups is related with increased mortality and extended hospitalization, according to the findings. These statistics imply that identifying and preventing risk factors is necessary. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information