Renal Involvement in Multisystem Inflammatory Syndrome in Children: Not Only Acute Kidney Injury
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Data Available (n) | Pathological Values (n) | Time of Detection | |
---|---|---|---|
AKI evaluation | |||
Creatinine and/or oliguria | 55 | 13/55 (23%) | On admission |
TD evaluation | |||
u-NAG | 19/55 | 15/19 (55%) | 2–17 * days (median: 6) |
Hypophospatemia | 51/55 | 38/51 (75%) | 1–10 * days (median: 2 days) |
TRP | 23/55 | 4/23 (17%) | 1–10 * days (median: 2 days) |
Polyuria | 55/55 | 723/55(14%) | During hospitalization course |
Other kidney involvement | |||
24 h Proteinuria | 26 | 9/26 (34%) (2 nephrotic, 7 non nephrotic) | During hospitalization course |
Hematuria | 35 | 8/35 (22%) | On hospital admission |
Variables | N (tot) | N (Frequence/Median), [IQR] |
---|---|---|
Male, n (%) | 55 | 34 (61.8) |
Age, yr (range) | 55 | 8 (1.2 to 17.5) |
Comorbidities (%) | 55 | 5 (9) |
Presenting symptoms, n (%) | ||
Gastrointestinal | 55 | 48 (87.3) |
Fluid losses | 55 | 35 (63.5) |
Abdominal pain | 55 | 43 (78.1) |
Cardiovascular | 55 | 49 (89.1) |
Systolic dysfunction | 44 | 36 (81.8) |
Mucocutaneous | 55 | 44 (80) |
Central Nervous System | 55 | 5 (9.1) |
Kidney involvement | 55 | 20 (36.6) |
AKI | 55 | 13 (23) |
Tubulopathy | 19 | 15 (78.9) |
AKI-TD | 15 | 8 (53.3) |
TD | 15 | 7 (46.6) |
Nephrotic proteinuria | 13 | 2 (15.8) |
Non nephrotic proteinuria | 13 | 7 (53.8) |
Microhematuria | 35 | 8 (22) |
Polyuria | 42 | 7 (16) |
Admission parameters | ||
WBC (cells/mmc) | 55 | 8810 [6825–12,895] |
Neutrophils (cells/mmc) | 55 | 7100 [4100–9165] |
PLT (cells/mmc) | 55 | 159,000 [104,500–244,500] |
CRP (mg/L) | 55 | 138 [90.25–210] |
PCT (ng/mL) | 45 | 4.8 [0.69–27] |
IL-1A (ng/L) | 36 | 2 [2–2.4] |
IL-1B (ng/L) | 36 | 6 [5–12.5] |
IL-6 (ng/L) | 36 | 46 [15.5–262] |
Urea (mmol/L) | 53 | 4.3 [3.15–6.91] |
Creatinina (umol/L) | 53 | 43 [34–63] |
Albumin (mg/lL) | 55 | 29.5 [27–34.75] |
Phosphate (mmol/L) | 51 | 1.15 [0.88–1.41] |
Bicarbonates (meq/L) | 23 | 22 [20.6–23.85] |
Troponin (ng/L) | 49 | 34 [8.8–99.5] |
NT-pro-BNP (ng/L) | 47 | 225.5 [126.75–922.75] |
TRP < 80 (%) | 23 | 4 (17.3) |
Variables | AKI Frequency Mean Value | No-AKI Frequency Mean Value | p |
---|---|---|---|
Clinical profile | |||
Male, n | 9/13 (69.2%) | 25/42 (59.5%) | 0.43 |
Comorbidities | 1/13 (7.7%) | 4/42 (10.5%) | 0.99 |
Nephrotoxic medications | 4/13 (30.8%) | 1/42 (2.4%) | 0.013 |
Fluid losses | 11/13 (84.6%) | 24/42 (57%) | 0.095 |
Systolic dysfunction | 10/11 (90.9%) | 26/33 (78.8%) | 0.64 |
Tubular Damage | 8/9 (88.9%) | 7/10 (70%) | 0.58 |
Inotropes | 6/13 (46.2%) | 3/42 (7.1%) | 0.002 |
PICU admission | 8/13 (61.5%) | 2/38 (5.3%) | <0.001 |
IL-1 inhibitor | 7/13 (53.8%) | 2/42 (4.8%) | <0.001 |
Polyuria | 4/13 (30.7%) | 3/36 | 0.070 |
Laboratory profile | |||
Neutrophils (cells/mmc) | 11,054.62 | 9175.95 | 0.092 |
Platelets (cells/mmc) | 156,230 | 202,618 | 0.22 |
CRP (mg/L) | 189.68 | 147 | 0.33 |
Procalcitonine (ng/mL) | 127.82 | 51.44 | 0.04 |
IL-6 (ng/L) | 294.76 | 63.18 | 0.007 |
IL-1a (ng/L) | 15 | 2 | 0.076 |
IL-1b (ng/L) | 20 | 13 | 0.55 |
D-dimer (ug/mL) | 2828.23 | 1478.16 | <0.001 |
Albumin (mg/L) | 30.15 | 30.3 | 0.92 |
CPK (U/L) | 256.85 | 181.64 | 0.60 |
AKI-TD (n = 8) Frequency/Mean Value | Isolated TD (n = 7) Frequency/Mean Value | |
---|---|---|
Fluid losses | 7/8 (87.5%) | 6/7 (85%) |
PICU admission | 7/8 (87.5%) | 0/7 (0%) |
IL-1 inhibitor | 6/8 (75%) | 0/7 (0%) |
Inotropes need | 5/8 (62%) | 0/7 (0%) |
Nephrotic proteinuria | 2/6 (33%) | 0/4 (0%) |
PCT (ng/mL) | 180 | 22 |
CRP (mg/L) | 220 | 153 |
Neutrophils (cells/mmc) | 11,251 | 6594 |
IL-6 (ng/L) | 367 | 131 |
IL-1a (ng/L) | 2 | 2 |
IL-1b (ng/L) | 10 | 9 |
Bicarbonates (mq/L) | 15 | 23 |
Hypophosphatemia (n = 38) Frequency | No Hypophosphatemia (n = 13) Frequency | p | |
---|---|---|---|
AKI | 10/38 (26.3%) | 3/13 (23.1%) | 1 |
TD | 10/14 (71.4%) | 5/5 (100%) | 0.5 |
TRP | 4/20 (20%) | 0/3 (0%) | 1 |
Inotropes need | 9/38 (23.7%) | 0/15 (0%) | 0.05 |
IL-1 inhibitor | 8/38 (21%) | 1/15 (7.6%) | 0.41 |
PCT (ng/mL) | 84 | 12 | 0.051 |
CRP (mg/L) | 155.5 | 155.3 | 0.88 |
IL-6 (ng/L) | 148 | 20 | 0.044 |
D-dimer (ug/mL) | 2357 | 891 | 0.12 |
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Meneghel, A.; Masenello, V.; Alfier, F.; Giampetruzzi, S.; Sembenini, C.; Martini, G.; Tirelli, F.; Meneghesso, D.; Zulian, F. Renal Involvement in Multisystem Inflammatory Syndrome in Children: Not Only Acute Kidney Injury. Children 2023, 10, 1661. https://doi.org/10.3390/children10101661
Meneghel A, Masenello V, Alfier F, Giampetruzzi S, Sembenini C, Martini G, Tirelli F, Meneghesso D, Zulian F. Renal Involvement in Multisystem Inflammatory Syndrome in Children: Not Only Acute Kidney Injury. Children. 2023; 10(10):1661. https://doi.org/10.3390/children10101661
Chicago/Turabian StyleMeneghel, Alessandra, Valentina Masenello, Fiorenza Alfier, Stefania Giampetruzzi, Camilla Sembenini, Giorgia Martini, Francesca Tirelli, Davide Meneghesso, and Francesco Zulian. 2023. "Renal Involvement in Multisystem Inflammatory Syndrome in Children: Not Only Acute Kidney Injury" Children 10, no. 10: 1661. https://doi.org/10.3390/children10101661