Journal article
Be aware of acute kidney injury in critically ill children with COVID-19
Pediatric nephrology (Berlin, West), Vol.36(1), pp.163-169
01/01/2021
DOI: 10.1007/s00467-020-04715-z
PMCID: PMC7447530
PMID: 32844290
Abstract
Acute kidney injury (AKI) is a common complication of critically ill adult patients with COVID-19. However, currently, no studies investigate kidney impairment in children with COVID-19. We investigated incidence and treatment of AKI in pediatric patients with COVID-19 in Wuhan Children's Hospital during the early stages of the COVID-19 pandemic and discuss possible mechanisms of AKI related to SARS-CoV-2 infection.
By extracting data from electronic medical records, we conducted a retrospective observational study of kidney involvement in confirmed pediatric COVID-19 cases in Wuhan Children's Hospital during the coronavirus outbreak, from January 24 to March 20, 2020. Clinical presentations, clinical courses, laboratory findings, and medical interventions are described below.
Among 238 confirmed COVID-19 cases, only three were critically ill and needed intensive care unit (ICU) admission. All three developed AKI, but AKI was not detected in any non-critically ill patients outside the ICU. Two of the three patients with AKI had prodromal gastrointestinal symptoms. Significantly elevated interleukin-6 (IL-6) levels and complement activation were observed in these patients with AKI. The three patients with AKI were treated with plasma exchange (PE) and continuous kidney replacement therapy (CKRT), resulting in one complete recovery, one partial recovery, and one mortality due to critical illness.
Critically ill children with COVID-19 may develop AKI, especially following prodromal gastrointestinal symptoms. An inflammatory storm and complement-mediated injury may underlie AKI development in children with COVID-19. Our study supports implantation of PE and CKRT in management of critically ill patients with AKI.
Details
- Title: Subtitle
- Be aware of acute kidney injury in critically ill children with COVID-19
- Creators
- Xiaowen Wang - Wuhan Children's HospitalXingfeng Chen - Wuhan Children's HospitalFeng Tang - Wuhan Children's HospitalWanjun Luo - Wuhan Children's HospitalJian Fang - Wuhan Children's HospitalChang Qi - Wuhan Children's HospitalHua Sun - Boston Children's HospitalHan Xiao - Wuhan Children's HospitalXuehua Peng - Wuhan Children's HospitalJianbo Shao - Wuhan Children's Hospital
- Resource Type
- Journal article
- Publication Details
- Pediatric nephrology (Berlin, West), Vol.36(1), pp.163-169
- DOI
- 10.1007/s00467-020-04715-z
- PMID
- 32844290
- PMCID
- PMC7447530
- ISSN
- 0931-041X
- eISSN
- 1432-198X
- Grant note
- WHCDCIRB-K-2020007 / Centers For Disease Control And Prevention of Wuhan WX16A07 / Key Projects of Scientific Research Program of Wuhan Health Commission me (CN) WJ2019M011 / Healthy Commission of Hubei Province 2016CFC728 / Natural Science Foundation of Hubei Province
- Language
- English
- Date published
- 01/01/2021
- Academic Unit
- Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics
- Record Identifier
- 9984384756502771
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