Acute Kidney Injury with SARS-CoV-2 Infection in Pediatric Patients Receiving High-Dose Methotrexate Chemotherapy: A Report of Three Cases
Background. Methotrexate is renally excreted. HDMTX (high dose-methotrexate)-induced acute kidney injury (AKI) is a non-oliguric decrease in glomerular filtration rate (GFR) heralded by an acute rise in serum creatinine. Moreover, AKI is also a frequent complication of COVID-19. Among our patients t...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/10/2/331 |
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| author | Olga Nigro Cristina Meazza Elisabetta Schiavello Veronica Biassoni Nadia Puma Luca Bergamaschi Giovanna Gattuso Giovanna Sironi Virginia Livellara Gabriele Papagni Maura Massimino |
| author_facet | Olga Nigro Cristina Meazza Elisabetta Schiavello Veronica Biassoni Nadia Puma Luca Bergamaschi Giovanna Gattuso Giovanna Sironi Virginia Livellara Gabriele Papagni Maura Massimino |
| author_sort | Olga Nigro |
| collection | DOAJ |
| description | Background. Methotrexate is renally excreted. HDMTX (high dose-methotrexate)-induced acute kidney injury (AKI) is a non-oliguric decrease in glomerular filtration rate (GFR) heralded by an acute rise in serum creatinine. Moreover, AKI is also a frequent complication of COVID-19. Among our patients treated with HDMTX, some of these developed AKI during SARS-CoV-2 infection. Therefore, we wondered whether our patients’ kidney failure might have been triggered by their underlying SARS-CoV-2 positivity. Methods. Data were collected from the database at the Pediatric Oncology Unit of the Istituto Nazionale dei Tumori in Milan (Italy) regarding patients who matched the following selective criteria: (a) treatment with HDMTX during the pandemic period; (b) SARS-CoV-2 infection during the treatment; (c) development of AKI during HDMTX treatment and SARS-CoV-2 infection. Results. From March 2020 to March 2022, a total of 23 patients were treated with HDMTX; 3 patients were treated with HDMTX during SARS-CoV-2 infection and all 3 developed AKI. Conclusions. Clinical manifestations associated with this virus are many, so we are not yet able to lower our guard and rule out this infection as a cause of clinical manifestations with any certainty. |
| first_indexed | 2024-03-11T09:00:28Z |
| format | Article |
| id | doaj.art-f442e099005241aea307056d05e73167 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-11T09:00:28Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-f442e099005241aea307056d05e731672023-11-16T19:49:22ZengMDPI AGChildren2227-90672023-02-0110233110.3390/children10020331Acute Kidney Injury with SARS-CoV-2 Infection in Pediatric Patients Receiving High-Dose Methotrexate Chemotherapy: A Report of Three CasesOlga Nigro0Cristina Meazza1Elisabetta Schiavello2Veronica Biassoni3Nadia Puma4Luca Bergamaschi5Giovanna Gattuso6Giovanna Sironi7Virginia Livellara8Gabriele Papagni9Maura Massimino10Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyDepartment of Anesthesia and Critical Care, Fondazione IRCCS Istituto Tumori di Milano, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyBackground. Methotrexate is renally excreted. HDMTX (high dose-methotrexate)-induced acute kidney injury (AKI) is a non-oliguric decrease in glomerular filtration rate (GFR) heralded by an acute rise in serum creatinine. Moreover, AKI is also a frequent complication of COVID-19. Among our patients treated with HDMTX, some of these developed AKI during SARS-CoV-2 infection. Therefore, we wondered whether our patients’ kidney failure might have been triggered by their underlying SARS-CoV-2 positivity. Methods. Data were collected from the database at the Pediatric Oncology Unit of the Istituto Nazionale dei Tumori in Milan (Italy) regarding patients who matched the following selective criteria: (a) treatment with HDMTX during the pandemic period; (b) SARS-CoV-2 infection during the treatment; (c) development of AKI during HDMTX treatment and SARS-CoV-2 infection. Results. From March 2020 to March 2022, a total of 23 patients were treated with HDMTX; 3 patients were treated with HDMTX during SARS-CoV-2 infection and all 3 developed AKI. Conclusions. Clinical manifestations associated with this virus are many, so we are not yet able to lower our guard and rule out this infection as a cause of clinical manifestations with any certainty.https://www.mdpi.com/2227-9067/10/2/331SARS-CoV-2COVID-19methotrexatepediatricrenal failureAKI |
| spellingShingle | Olga Nigro Cristina Meazza Elisabetta Schiavello Veronica Biassoni Nadia Puma Luca Bergamaschi Giovanna Gattuso Giovanna Sironi Virginia Livellara Gabriele Papagni Maura Massimino Acute Kidney Injury with SARS-CoV-2 Infection in Pediatric Patients Receiving High-Dose Methotrexate Chemotherapy: A Report of Three Cases Children SARS-CoV-2 COVID-19 methotrexate pediatric renal failure AKI |
| title | Acute Kidney Injury with SARS-CoV-2 Infection in Pediatric Patients Receiving High-Dose Methotrexate Chemotherapy: A Report of Three Cases |
| title_full | Acute Kidney Injury with SARS-CoV-2 Infection in Pediatric Patients Receiving High-Dose Methotrexate Chemotherapy: A Report of Three Cases |
| title_fullStr | Acute Kidney Injury with SARS-CoV-2 Infection in Pediatric Patients Receiving High-Dose Methotrexate Chemotherapy: A Report of Three Cases |
| title_full_unstemmed | Acute Kidney Injury with SARS-CoV-2 Infection in Pediatric Patients Receiving High-Dose Methotrexate Chemotherapy: A Report of Three Cases |
| title_short | Acute Kidney Injury with SARS-CoV-2 Infection in Pediatric Patients Receiving High-Dose Methotrexate Chemotherapy: A Report of Three Cases |
| title_sort | acute kidney injury with sars cov 2 infection in pediatric patients receiving high dose methotrexate chemotherapy a report of three cases |
| topic | SARS-CoV-2 COVID-19 methotrexate pediatric renal failure AKI |
| url | https://www.mdpi.com/2227-9067/10/2/331 |
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