Iranian Journal of Kidney Diseases, Vol 17, No 1 (2023)

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Acute Kidney Injury in Pediatric Patients with COVID-19; Clinical Features and Outcome

Mahbubeh Mirzaee, Mahnaz Jamee, Masoumeh Mohkam, Fatemeh Abdollah Gorji, Mitra Khalili, Sedigheh Rafiei Tabatabaei, Abdollah Karimi, Shahnaz Armin, Roxana Mansour Ghanaie, Seyed Alireza Fahimzad, Zahra Pournasiri, Seyed Mohammad Taghi Hosseini Tabatabaei, Reza Dalirani, Nasrin Esfandiar, Mina Alibeik


Introduction. Renal disorders have been reported as the underlying cause as well as complications of critical COVID-19 in pediatric patients. The purpose of this study was to investigate the pattern of kidney involvement, particularly acute kidney injury (AKI), among pediatric patients with COVID-19. Methods. In this prospective study, hospitalized pediatric patients with a clinical diagnosis of COVID-19 were enrolled. Demographic, clinical, and laboratory findings were collected and analyzed using a mixed method of qualitative and quantitative approaches and descriptive statistics. Results. One hundred and eighty-seven patients, including 120 (64.2%) males and 67 (35.8%) females with COVID-19 with a median age (interquartile range) of 60 (24 to 114) months were enrolled in this study. Most patients (n = 108, 58.1%) had one or two underlying comorbidities, mainly malnutrition (77.4%), neurologic/learning disorders (21.4%), and malignancy (10.2%). According to the Kidney Disease Improving Global Outcomes (KDIGO) classification, AKI was detected in 38.5% of patients (stage 1: 55.6%, stage 2: 36.1%, and stage 3: 8.3%) at presentation or during hospitalization. Nine patients (4.8%) required hemodialysis and 16 (8.6%) eventually died. There was no significant association between AKI and admission to the pediatric intensive care unit (PICU) (P > .05), a multisystem inflammatory syndrome in children (MIS-C) (P > .05), comorbidities (P > .05), and mortality rate (P > .05). Conclusion. Kidneys are among the major organs affected by COVID-19. Although kidney abnormalities resolve in the majority of pediatric COVID-19 infections, particular attention should be paid to serum creatinine and electrolyte levels in patients affected by COVID-19, particularly children with a history of malnutrition and kidney disorders.


DOI: 10.52547/ijkd.7151

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