Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct;38(10):3475-3482.
doi: 10.1007/s00467-023-05987-x. Epub 2023 May 12.

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

Hasan Özen  1 , Ayşen Durak Aslan  2 , Burak Balaban  3 , Oktay Perk  4 , Hacer Uçmak  3 , Serhan Özcan  4 , Anar Gurbanov  3 , Emel Uyar  4 , Fevzi Kahveci  3 , Emrah Gün  3 , Ali Kansu Tehci  5 , Serhat Emeksiz  4 , Tanıl Kendirli  3
Affiliations

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

Hasan Özen et al. Pediatr Nephrol. 2023 Oct.

Abstract

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. A higher resolution version of the Graphical abstract is available as Supplementary information.

Keywords: Acute kidney injury; Multisystem inflammatory syndrome; Pediatric intensive care; SARS-CoV-2.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

None
A higher resolution version of the Graphical abstract is available as Supplementary information
Fig. 1
Fig. 1
Flowchart of study population. Acute kidney injury (AKI) was staged by Kidney Disease: Improving Global Outcomes (KDIGO) criteria. COVID-19, coronavirus disease 2019; MIS-C, multisystem inflammatory syndrome in children
See this image and copyright information in PMC

References

    1. Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A, Iosifidis C, Agha R. World Health Organization declares global emergency: a review of the novel coronavirus (2019) (COVID-19) Int J Surg. 2020;76:71–76. doi: 10.1016/j.ijsu.2020.02.034. - DOI - PMC - PubMed
    1. Gabarre P, Dumas G, Dupont T, Darmon M, Azoulay E, Zafrani L. Acute kidney injury in critically ill patients with COVID-19. Intensive Care Med. 2020;46:1339–1348. doi: 10.1007/s00134-020-06153-9. - DOI - PMC - PubMed
    1. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease (2019) (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323:1239–1242. doi: 10.1001/jama.2020.2648. - DOI - PubMed
    1. Royal College of Paediatrics and Child Health . Paediatric multisystem inflammatory syndrome (PIMS) temporally associated with COVID-19 - guidance for clinicians. 2020.
    1. Centers for Disease Control and Prevention. National Center for Immunization and Respiratory Diseases (U.S.) Health department-reported cases of multisystem inflammatory syndrome in children (MIS-C) in the United States. 2021.

Supplementary concepts