Abstract
Objective
To determine the incidence, risk factors and outcome of acute kidney injury (AKI) in hospitalized children with nephrotic syndrome.
Methods
All consecutive hospitalized children (aged 1–14 years) with diagnosis of nephrotic syndrome between February 2016 and January 2017 were enrolled for the study. Children (aged 1–14 years) with features of nephritis, underlying secondary causes of nephrotic syndrome as well as children admitted for diagnostic renal biopsy and intravenous cyclophosphamide or rituximab infusion were excluded.
Results
A total of 73 children (81 admissions) were enrolled; incidence of AKI was 16% (95% CI, 9-23). On multivariate logistic regression analysis, furosemide infusion was observed as an independent risk factor for acute kidney injury (OR 23; 95% CI, 3-141; P<0.001). Out of 13 children with AKI, three died.
Conclusions
Acute kidney injury in hospitalized children with nephrotic syndrome has high risk of mortality. Children receiving furosemide infusion should be closely monitored for occurrence of acute kidney injury.
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References
Sakarcan A, Timmons C, Seikaly MG. Reversible idiopathic acute renal failure in children with primary nephrotic syndrome. J Pediatr. 1994;125:723–7.
Cavagnaro F, Lagomarsino E. Peritonitis as a risk factor of acute renal failure in nephrotic children. Pediatr Nephrol. 2000;15:248–51.
Smith JD, Hayslett JP. Reversible renal failure in the nephrotic syndrome. Am J Kidney Dis. 1992;19:201–13.
Rheault MN, Wei CC, Hains DS, Wang W, Kerlin BA, Smoyer WE. Increasing frequency of acute kidney injury amongst children hospitalized with nephrotic syndrome. Pediatr Nephrol. 2014;29:139–47
Meyrier A, Niaudet P. Acute kidney injury complicating nephrotic syndrome of minimal change disease. Kidney Int. 2018;94:861–9.
Agarwal N, Phadke KD, Garg I, Alexander P. Acute renal failure in children with idiopathic nephrotic syndrome. Pediatr Nephrol. 2003;18:1289–92.
Rheault MN, Zhang L, Selewski DT, Kallash M, Tran CL, Seamon M, et al. Midwest Pediatric Nephrology Consortium. AKI in children hospitalized with nephrotic syndrome. Clin J Am Soc Nephrol. 2015;10:2110–8.
Indian Pediatric Nephrology Group, Indian Academy of Pediatrics, Bagga A, Ali U, Banerjee S, Kanitkar M, Phadke KD, Senguttuvan P, et al. Management of Steroid Sensitive Nephrotic Syndrome: Revised Guidelines. Indian Pediatr. 2008;45:203–14.
Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int. 2012;2(S):1–138.
Ceriotti F, Boyd JC, Klein G, Henny J, Queraltó J, Kairisto V, et al. IFCC Committee on Reference Intervals and Decision Limits (C–RIDL). Reference intervals for serum creatinine concentrations: assessment of available data for global application. Clin Chem. 2008;54:559–66.
Loghman–Adham M, Siegler RL, Pysher TJ. Acute renal failure in idiopathic nephrotic syndrome. Clin Nephrol. 1997;47:76–80.
Lowenstein J, Schacht RG, Baldwin DS. Renal failure in minimal change nephrotic syndrome. Am J Med. 1981;70:227–33.
Venkataseshan VS, Faraggiana T, Grishman E, Marquet E, Churg J. Renal failure due to tubular obstruction by large protein casts in patients with massive proteinuria. Clin Nephrol. 1993;39:321–6.
Vande Walle J, Mauel R, Raes A, Vandekerckhove K, Donckerwolcke R. ARF in children with minimal change nephrotic syndrome may be related to functional changes of the glomerular basal membrane. Am J Kidney Dis. 2004;43:399–404.
Yaseen A, Tresa V, Lanewala AA, Hashmi S, Ali I, Khatri S, Mubarak M. Acute kidney injury in idiopathic nephrotic syndrome of childhood is a major risk factor for the development of chronic kidney disease. Ren Fail. 2017;39:323–27.
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Prasad, B.S., Kumar, M., Dabas, A. et al. Profile of Acute Kidney Injury in Hospitalized Children with Idiopathic Nephrotic Syndrome. Indian Pediatr 56, 119–122 (2019). https://doi.org/10.1007/s13312-019-1483-9
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DOI: https://doi.org/10.1007/s13312-019-1483-9