Journal article
Acute Kidney Injury Among Children Admitted With Viral Rhabdomyolysis
Hospital pediatrics, Vol.11(8), pp.878-885
08/2021
DOI: 10.1542/hpeds.2020-005108
PMID: 34301717
Abstract
Infectious etiologies cause a large portion of pediatric rhabdomyolysis. Among pediatric patients with rhabdomyolysis, it is unknown who will develop acute kidney injury (AKI). We sought to test the hypothesis that a viral etiology would be associated with less AKI in children admitted with rhabdomyolysis than a nonviral etiology.
In this single-center retrospective cohort study, patients <21 years of age admitted with acute rhabdomyolysis from May 1, 2010, through December 31, 2018, were studied. The primary outcome was development of AKI, defined by using the Kidney Disease: Improving Global Outcomes guidelines. The primary predictor was identification of viral infection by laboratory testing or clinical diagnosis. Covariates included age, sex, race, insurance provider, presence of proteinuria and myoglobinuria, and initial creatinine kinase and serum urea nitrogen. Routine statistics and multivariable logistic modeling were performed via SAS 9.4 (SAS Institute, Inc, Cary, NC).
In total, 319 pediatric patients with rhabdomyolysis were studied. The median age was 13 years. Patients were predominately male (69.9%), non-Hispanic Black (55.2%), and publicly insured (45.1%). We found no difference in the rates of AKI in those with a viral diagnosis versus those without a viral diagnosis (30 of 77 [39.0%] vs 111 of 234 [47.4%];
= .19). Multivariable analysis revealed that viral diagnosis was not associated with the development of AKI. Patients ≥13 years of age, male patients, and those with proteinuria and elevated serum urea nitrogen on admission had increased odds of developing AKI.
In our study, viral rhabdomyolysis did not have lower rates of AKI compared with nonviral etiologies of AKI; therefore, providers should consider continued caution in these patients.
Details
- Title: Subtitle
- Acute Kidney Injury Among Children Admitted With Viral Rhabdomyolysis
- Creators
- Hannah M Gardner - University of Colorado HospitalDavid J Askenazi - Pediatric Nephrology of AlabamaJennifer A Hoefert - Cardinal Glennon Children’s Medical CenterAlexis Helton - University of Alabama at BirminghamChang L Wu - Pediatric Hospital Medicine, Department of Pediatrics
- Resource Type
- Journal article
- Publication Details
- Hospital pediatrics, Vol.11(8), pp.878-885
- DOI
- 10.1542/hpeds.2020-005108
- PMID
- 34301717
- ISSN
- 2154-1663
- eISSN
- 2154-1671
- Grant note
- UL1 TR001417 / NCATS NIH HHS UL1 TR003096 / NCATS NIH HHS R01 FD005092 / FDA HHS
- Language
- English
- Date published
- 08/2021
- Academic Unit
- Stead Family Department of Pediatrics
- Record Identifier
- 9985221142002771
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