A retrospective analysis of acute kidney injury in children with post-COVID-19 multisystem inflammatory syndrome: insights into promising outcomes
Abstract Background Acute kidney injury (AKI) in patients with multisystem inflammatory syndrome (MIS), COVID-19 related infection has been increasingly recognized with a paucity of data on AKI incidence, related mortality, and the requirement of renal replacement therapy in children with MIS (MIS-C...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | Italian Journal of Pediatrics |
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| Online Access: | https://doi.org/10.1186/s13052-024-01598-w |
| _version_ | 1827326663578353664 |
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| author | Hanan El-Halaby Riham Eid Ahmed Elagamy Ahmed El-Hussiny Fatma Moustafa Ayman Hammad Mayada Zeid |
| author_facet | Hanan El-Halaby Riham Eid Ahmed Elagamy Ahmed El-Hussiny Fatma Moustafa Ayman Hammad Mayada Zeid |
| author_sort | Hanan El-Halaby |
| collection | DOAJ |
| description | Abstract Background Acute kidney injury (AKI) in patients with multisystem inflammatory syndrome (MIS), COVID-19 related infection has been increasingly recognized with a paucity of data on AKI incidence, related mortality, and the requirement of renal replacement therapy in children with MIS (MIS-C). Methods This is a retrospective study evaluating the prevalence, severity, management and outcomes of AKI in a cohort of Egyptian children with MIS-children (MIS-C) post-COVID infection. Patients were included if they met the criteria for MIS-C based on CDC guidelines. All patients were evaluated for AKI diagnosis and staging according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Results Between March 2021 and June 2023, a total of 655 confirmed COVID-19 cases were admitted and then followed up in our hospital, of whom 138 (21%) were diagnosed with MIS-C. Fifty-one patients developed AKI associated with MIS-C post-COVID infection, 42 of whom were included in the analysis. Thirty-one patients had AKI in a formerly healthy kidney, of whom 51% (16 patients) were classified as KDIGO stage 3, 5 patients needed hemodialysis and 13 needed mechanical ventilation. Higher WBCs count, and serum ferritin on admission were associated with more severe AKI (KDIGO stage 3) (p = 0.04), while multivariate analysis showed high serum ferritin to be independent predictor of more severe AKI (p = 0.02). Two patients (2/31) died during hospital admission, while no residual renal impairment was reported at the time of discharge of patients with previously normal kidney functions. Conclusion More than one-third of patients with MIS-C develop AKI. Avoidance of nephrotoxic drugs, early recognition, and prompt management of AKI, including well-timed commencement of dialysis in MIS-C cases, is associated with favorable outcomes. |
| first_indexed | 2024-03-07T14:48:51Z |
| format | Article |
| id | doaj.art-a8cd43ca5c6d40a49c0fdbce5100dd8d |
| institution | Directory Open Access Journal |
| issn | 1824-7288 |
| language | English |
| last_indexed | 2024-03-07T14:48:51Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Italian Journal of Pediatrics |
| spelling | doaj.art-a8cd43ca5c6d40a49c0fdbce5100dd8d2024-03-05T19:48:42ZengBMCItalian Journal of Pediatrics1824-72882024-02-0150111110.1186/s13052-024-01598-wA retrospective analysis of acute kidney injury in children with post-COVID-19 multisystem inflammatory syndrome: insights into promising outcomesHanan El-Halaby0Riham Eid1Ahmed Elagamy2Ahmed El-Hussiny3Fatma Moustafa4Ayman Hammad5Mayada Zeid6Pediatric Critical Care Unit, Mansoura University Children’s Hospital, Faculty of Medicine, Mansoura UniversityPediatric Nephrology Unit, Mansoura University Children’s Hospital, Faculty of Medicine, Mansoura UniversityPediatric Critical Care Unit, Mansoura University Children’s Hospital, Faculty of Medicine, Mansoura UniversityPediatric Critical Care Unit, Mansoura University Children’s Hospital, Faculty of Medicine, Mansoura UniversityDepartment of Pathology, Faculty of Medicine, Mansoura UniversityPediatric Nephrology Unit, Mansoura University Children’s Hospital, Faculty of Medicine, Mansoura UniversityPediatric Infectious Diseases Unit, Mansoura University Children’s Hospital, Faculty of Medicine, Mansoura UniversityAbstract Background Acute kidney injury (AKI) in patients with multisystem inflammatory syndrome (MIS), COVID-19 related infection has been increasingly recognized with a paucity of data on AKI incidence, related mortality, and the requirement of renal replacement therapy in children with MIS (MIS-C). Methods This is a retrospective study evaluating the prevalence, severity, management and outcomes of AKI in a cohort of Egyptian children with MIS-children (MIS-C) post-COVID infection. Patients were included if they met the criteria for MIS-C based on CDC guidelines. All patients were evaluated for AKI diagnosis and staging according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Results Between March 2021 and June 2023, a total of 655 confirmed COVID-19 cases were admitted and then followed up in our hospital, of whom 138 (21%) were diagnosed with MIS-C. Fifty-one patients developed AKI associated with MIS-C post-COVID infection, 42 of whom were included in the analysis. Thirty-one patients had AKI in a formerly healthy kidney, of whom 51% (16 patients) were classified as KDIGO stage 3, 5 patients needed hemodialysis and 13 needed mechanical ventilation. Higher WBCs count, and serum ferritin on admission were associated with more severe AKI (KDIGO stage 3) (p = 0.04), while multivariate analysis showed high serum ferritin to be independent predictor of more severe AKI (p = 0.02). Two patients (2/31) died during hospital admission, while no residual renal impairment was reported at the time of discharge of patients with previously normal kidney functions. Conclusion More than one-third of patients with MIS-C develop AKI. Avoidance of nephrotoxic drugs, early recognition, and prompt management of AKI, including well-timed commencement of dialysis in MIS-C cases, is associated with favorable outcomes.https://doi.org/10.1186/s13052-024-01598-wAcute kidney injuryMultisystem inflammatory diseaseMIS-CCOVID-19Children |
| spellingShingle | Hanan El-Halaby Riham Eid Ahmed Elagamy Ahmed El-Hussiny Fatma Moustafa Ayman Hammad Mayada Zeid A retrospective analysis of acute kidney injury in children with post-COVID-19 multisystem inflammatory syndrome: insights into promising outcomes Italian Journal of Pediatrics Acute kidney injury Multisystem inflammatory disease MIS-C COVID-19 Children |
| title | A retrospective analysis of acute kidney injury in children with post-COVID-19 multisystem inflammatory syndrome: insights into promising outcomes |
| title_full | A retrospective analysis of acute kidney injury in children with post-COVID-19 multisystem inflammatory syndrome: insights into promising outcomes |
| title_fullStr | A retrospective analysis of acute kidney injury in children with post-COVID-19 multisystem inflammatory syndrome: insights into promising outcomes |
| title_full_unstemmed | A retrospective analysis of acute kidney injury in children with post-COVID-19 multisystem inflammatory syndrome: insights into promising outcomes |
| title_short | A retrospective analysis of acute kidney injury in children with post-COVID-19 multisystem inflammatory syndrome: insights into promising outcomes |
| title_sort | retrospective analysis of acute kidney injury in children with post covid 19 multisystem inflammatory syndrome insights into promising outcomes |
| topic | Acute kidney injury Multisystem inflammatory disease MIS-C COVID-19 Children |
| url | https://doi.org/10.1186/s13052-024-01598-w |
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