scholarly journals Acute kidney injury in children with COVID-19: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jameela Abdulaziz Kari ◽  
Mohamed A Shalaby ◽  
Amr S Albanna ◽  
Turki S Alahmadi ◽  
Adi Alherbish ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Impairment ◽  
Hospital Admission ◽  
Respiratory Distress ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Mortality And Morbidity ◽  
Reactive Protein ◽  
Renal Angina Index ◽  
Renal Angina

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.

scholarly journals Acute Kidney Injury in Children with COVID-19

2020 ◽  
Author(s):  
Jameela A kari ◽  
Mohamed Shalaby ◽  
Amr S Albanna ◽  
Turki Alahmadi ◽  
Adi Alherbish ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Impairment ◽  
Hospital Admission ◽  
Respiratory Distress ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Mortality And Morbidity ◽  
Reactive Protein ◽  
Renal Angina Index ◽  
Renal Angina

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). 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.

scholarly journals Renal angina index predicts fluid overload in critically ill children: an observational cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stephen M. Gorga ◽  
Erin F. Carlton ◽  
Joseph G. Kohne ◽  
Ryan P. Barbaro ◽  
Rajit K. Basu
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Fluid Overload ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Critically Ill Children ◽  
Poor Outcomes ◽  
Renal Angina Index ◽  
Renal Angina

Abstract Background Fluid overload and acute kidney injury are common and associated with poor outcomes among critically ill children. The prodrome of renal angina stratifies patients by risk for severe acute kidney injury, but the predictive discrimination for fluid overload is unknown. Methods Post-hoc analysis of patients admitted to a tertiary care pediatric intensive care unit (PICU). The primary outcome was the performance of renal angina fulfillment on day of ICU admission to predict fluid overload ≥15% on Day 3. Results 77/139 children (55%) fulfilled renal angina (RA+). After adjusting for covariates, RA+ was associated with increased odds of fluid overload on Day 3 (adjusted odds ratio (aOR) 5.1, 95% CI 1.23–21.2, p = 0.025, versus RA-). RA- resulted in a 90% negative predictive value for fluid overload on Day 3. Median fluid overload was significantly higher in RA+ patients with severe acute kidney injury compared to RA+ patients without severe acute kidney injury (% fluid overload on Day 3: 8.8% vs. 0.73%, p = 0.002). Conclusion Among critically ill children, fulfillment of renal angina was associated with increased odds of fluid overload versus the absence of renal angina and a higher fluid overload among patients who developed acute kidney injury. Renal angina directed risk classification may identify patients at highest risk for fluid accumulation. Expanded study in larger populations is warranted.

scholarly journals Urinary NGAL incorporation into Renal Angina Index for early detection of acute kidney injury in critically ill children

2019 ◽  
Vol 3 (2) ◽  
pp. 093-099 ◽  
Author(s):  
Ali Mohammed Abu Zeid ◽  
Doaa Youssef Mohammed* ◽  
Amal Saeed AbdAlazeem ◽  
Anas Saad Elsayed Mohammed Seddeeq ◽  
Ashraf Mohamed Elnaany
Keyword(s):  
Acute Kidney Injury ◽  
Early Detection ◽  
Critically Ill ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Urinary Ngal ◽  
Renal Angina Index ◽  
Renal Angina

Diagnostic accuracy of renal angina index alone or in combination with biomarkers for predicting acute kidney injury in children

2022 ◽  
Author(s):  
Jitendra Meena ◽  
Jogender Kumar ◽  
Christy Cathreen Thomas ◽  
Lesa Dawman ◽  
Karalanglin Tiewsoh ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Diagnostic Accuracy ◽  
Kidney Injury ◽  
Renal Angina Index ◽  
Renal Angina

Relationship Between Renal Angina Index and D-Dimer Improvement Towards Acute Kidney Injury in Covid-19 Patients in Special Isolation Room of Dr. Soetomo Hospital Surabaya

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Fadhil Rasyid ◽  
Bambang Pujo Semedi ◽  
Arie Utariani ◽  
Teuku Aswin
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
World Health ◽  
Isolation Room ◽  
Injury Criteria ◽  
Health Organization ◽  
Renal Angina Index ◽  
Renal Angina ◽  
D Dimer

Since the World Health Organization (WHO) declared COVID-19 as pandemic in March 2020, the number of new case findings in Indonesia has continued to increase. As happened in the city of Surabaya. Even in severe cases deterioration is rapid and progressive. One of them is the high D-dimer level in COVID-19 patients, which indicates the presence of vascular thrombosis, resulting in organ failure syndromes such as Acute Kidney Injury (AKI). Such conditions clearly indicate that this virus attacks the kidneys. It is known that the prevalence of AKI is 17%, where 77% of AKI patients experienced severe COVID-19 infection, and 52% died. For this reason, this study was prepared with the aim of knowing the relationship between increased levels of D-Dimer Renal Angine Index and the incidence of Acute Kidney Injury (AKI) in COVID-19 patients in the Special Isolation Room of Dr. Soetomo Hospital Surabaya. This study was a retrospective cohort analytic observational study with a sample size of 30. The Acute Kidney Injury criteria in this study used an increase in serum creatinine ≥ 0.3 mg / dL within 48 hours, or an increase in serum creatinine ≥ 1.5 times. Through research conducted, it is known that the Renal Angina Index can be used to predict the incidence of AKI in this study with p <0.0001 and sensitivity 71%, specificity 21% (r: 0.43; strong CC> 0.3) with a limit of 7. It can be concluded that there is a relationship which is significant between the Renal Angina Index on the incidence of Acute Kidney Injury (AKI). However, there was no significant relationship between increased D-Dimer levels and the incidence of acute kidney injury.

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