Journal article
Acute kidney injury requiring kidney replacement therapy in childhood lupus nephritis: a cohort study of the Pediatric Nephrology Research Consortium and Childhood Arthritis and Rheumatology Research Alliance
Pediatric nephrology (Berlin, West), Vol.38(5), pp.1653-1665
05/2023
DOI: 10.1007/s00467-022-05775-z
PMCID: PMC12498489
PMID: 36251074
Abstract
Background Acute kidney injury (AKI) is common in lupus nephritis (LN) and a risk factor for development of chronic kidney disease. In adults with LN, AKI severity correlates with the incidence of kidney failure and patient survival. Data on AKI outcomes in children with LN, particularly those requiring kidney replacement therapy (KRT), are limited.
Methods A multicenter, retrospective cohort study was performed in children diagnosed between 2010 and 2019 with LN and AKI stage 3 treated with dialysis (AKI stage 3D). Descriptive statistics were used to characterize demographics, clinical data, and kidney biopsy findings; treatment data for LN were not included. Logistic regression was used to examine the association of these variables with kidney failure.
Results Fifty-nine patients (mean age 14.3 years, 84.7% female) were identified. The most common KRT indications were fluid overload (86.4%) and elevated blood urea nitrogen/creatinine (74.6%). Mean follow-up duration was 3.9 +/- 2.9 years. AKI recovery without progression to kidney failure occurred in 37.3% of patients. AKI recovery with later progression to kidney failure occurred in 25.4% of patients, and there was no kidney recovery from AKI in 35.6% of patients. Older age, severe (> 50%) tubular atrophy and interstitial fibrosis, and National Institutes of Health (NIH) chronicity index score > 4 on kidney biopsy were associated with kidney failure.
Conclusions Children with LN and AKI stage 3D have a high long-term risk of kidney failure. Severe tubular atrophy and interstitial fibrosis at the time of AKI, but not AKI duration, are predictive of kidney disease progression.
Details
- Title: Subtitle
- Acute kidney injury requiring kidney replacement therapy in childhood lupus nephritis: a cohort study of the Pediatric Nephrology Research Consortium and Childhood Arthritis and Rheumatology Research Alliance
- Creators
- Brian R. Stotter - St. Louis Children's HospitalEllen Cody - Cincinnati Children's Hospital Medical CenterHongjie Gu - Washington University in St. Louis School of MedicineAnkana Daga - Boston Childrens Hosp, Div Nephrol, Boston, MA USALarry A. Greenbaum - Emory UniversityMinh Dien Duong - Albert Einstein Coll Med, Childrens Hosp Montefiore, Div Nephrol, Bronx, NY 10467 USAAlexandra Mazo - Albert Einstein Coll Med, Childrens Hosp Montefiore, Div Nephrol, Bronx, NY 10467 USABeatrice Goilav - Albert Einstein Coll Med, Childrens Hosp Montefiore, Div Nephrol, Bronx, NY 10467 USAAlexis Boneparth - Columbia UniversityMahmoud Kallash - Nationwide Childrens Hosp, Div Nephrol, Columbus, OH USAAhmed Zeid - Nationwide Childrens Hosp, Div Nephrol, Columbus, OH USAWacharee Seeherunvong - University of MiamiRebecca R. Scobell - Childrens Hosp Philadelphia, Philadelphia, PA 19104 USAIssa Alhamoud - University of IowaCaitlin E. Carter - Univ Calif San Diego, Dept Pediat, Div Pediat Nephrol, San Diego, CA 92103 USASiddharth Shah - Norton Childrens Hosp, Dept Pediat Nephrol, Louisville, KY USACaroline E. Straatmann - LSU Hlth & Childrens Hosp, New Orleans, LA USABradley P. Dixon - University of Colorado Cancer CenterJennifer C. Cooper - University of Colorado HospitalRaoul D. Nelson - University of UtahDeborah M. Levy - University of TorontoHermine Brunner - Cincinnati Children's Hospital Medical CenterPriya S. Verghese - Ann & Robert H Lurie Childrens Hosp Chicago, Chicago, IL USAScott E. Wenderfer - University of British Columbia
- Resource Type
- Journal article
- Publication Details
- Pediatric nephrology (Berlin, West), Vol.38(5), pp.1653-1665
- DOI
- 10.1007/s00467-022-05775-z
- PMID
- 36251074
- PMCID
- PMC12498489
- NLM abbreviation
- Pediatr Nephrol
- ISSN
- 0931-041X
- eISSN
- 1432-198X
- Publisher
- Springer Nature
- Number of pages
- 13
- Language
- English
- Electronic publication date
- 10/17/2022
- Date published
- 05/2023
- Academic Unit
- Stead Family Department of Pediatrics
- Record Identifier
- 9984353809102771
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