Acute Kidney Injury in Children with Acute Appendicitis

Marzuillo, Pierluigi; Coppola, Clara; Caiazzo, Roberta; Macchini, Giulia; Sessa, Anna Di; Guarino, Stefano; Esposito, Francesco; Giudice, Emanuele Miraglia del; Tipo, Vincenzo

doi:10.3390/children9050620

Cited by 9 publications

(9 citation statements)

References 17 publications

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“…During the hospitalization, none of our patients was diagnosed with AKI. This, in addition to the presence of only one report describing an association between AKI and bronchiolitis [ 8 ], further confirms our meaning that AKI, especially in its milder forms, is often under-recognized in children [ 4 – 7 ].…”

Section: Discussionsupporting

confidence: 85%

“…Our study group previously analyzed both prevalence of and factors associated with AKI in different groups of children [ 4 – 7 ]. In children with acute gastroenteritis, we found lower birth weight and higher hematocrit levels in patients who developed AKI compared with those who did not [ 6 ], while in children with community-acquired pneumonia, we found lower birth weight and higher percentage of preterm birth in patients developing AKI compared with those who did not [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies, our research group showed that acute kidney injury (AKI) can complicate several common pediatric conditions and that it can be frequently under-recognized in children, especially in case of mild forms [ 4 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Acute kidney injury in infants hospitalized for viral bronchiolitis

et al. 2023

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We investigated prevalence of and factors associated with acute kidney injury (AKI) in a group of patients hospitalized with viral bronchiolitis. We retrospectively enrolled 139 children (mean age = 3.2 ± 2.1 months; males = 58.9%) hospitalized for viral bronchiolitis in a non-pediatric intensive care unit (PICU) setting. The Kidney Disease/Improving Global Outcomes creatinine criterion was used to diagnose AKI. We estimated basal serum creatinine by back-calculating it by Hoste (age) equation assuming that basal eGFR were the median age-based eGFR normative values. Univariate and multivariate logistic regression models were used to explore associations with AKI. Out of 139 patients, AKI was found in 15 (10.8%). AKI was found in 13 out of 74 (17.6%) patients with and in 2 out of 65 (3.1%) without respiratory syncytial virus (RSV) infection (p = 0.006). No patient required renal replacement therapies, while 1 out of 15 (6.7%) developed AKI stage 3, 1 (6.7%) developed AKI stage 2, and 13 (86.6%) developed AKI stage 1. Among the 15 patients with AKI, 13 (86.6%) reached the maximum AKI stage at admission, 1 (6.7%) at 48 h, and 1 (6.7%) at 96 h. At multivariate analysis, birth weight < 10th percentile (odds ratio, OR = 34.1; 95% confidence interval, CI = 3.6–329.4; p = 0.002), preterm birth (OR = 20.3; 95% CI = 3.1–129.5; p = 0.002), RSV infection (OR = 27.0; 95% CI = 2.6–279.9; p = 0.006), and hematocrit levels > 2 standard deviation score (SDS) (OR = 22.4; 95% CI = 2.8–183.6; p = 0.001) were significantly associated with AKI.Conclusion: About 11% of patients hospitalized with viral bronchiolitis in a non-PICU setting develop an AKI (frequently mild in degree). Preterm birth, birth weight < 10th percentile, hematocrit levels > 2SDS, and RSV infection are significantly associated with AKI in the setting of viral bronchiolitis. What is Known:• Viral bronchiolitis affects children in the first months of life and in 7.5% of cases it can be complicated by acute kidney injury (AKI).• No studies investigated associations with AKI in infants hospitalized for viral bronchiolitis. What is New:• About 11% of patients hospitalized with viral bronchiolitis can develop an AKI (frequently mild in degree).• Preterm birth, birth weight <10th percentile, hematocrit levels > 2 standard deviation score, and respiratory syncytial virus infection are associated with AKI development in infants with viral bronchiolitis.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Acute kidney injury in infants hospitalized for viral bronchiolitis

et al. 2023

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“…Comparing the prevalence of AKI in malaria against other diseases, the prevalence of AKI reported in this study was comparable with the one reported by Marzuillo et al [ 13 ] among children with diabetes mellitus (43.8%). However, it was significantly higher than in acute gastroenteritis (24.6%), community acquired pneumonia (20.4%), and acute appendicitis (7.4%) [ 14 – 16 ].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Acute Kidney Injury among Children with Severe Malaria at Kiryandongo General Hospital, Uganda

Kwambele,

Ndeezi,

Ortiz

et al. 2023

International Journal of Pediatrics

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Background. Malaria remains one of the leading health problems of the developing world, and acute kidney injury (AKI) is a well-recognized complication of severe malaria in adults; but the clinical importance of AKI in paediatric severe malaria is not well documented. Knowledge of the prevalence and factors associated with AKI among children with severe malaria is among the key strategies, which can help to reduce the burden of AKI among this vulnerable group. Methodology. A hospital-based prospective cross-sectional descriptive and analytic study of children with severe malaria was carried out at Kiryandongo General Hospital. The study involved 350 children with severe malaria attending the study site from August to October 2021. Questionnaires were administered to caretakers to obtain sociodemographic characteristics. Medical data were obtained through physical examination followed by laboratory tests. Blood samples were tested for creatinine and blood smear for malaria. Data were analyzed using binary logistic regression (bivariate and multivariate) to assess for the factors associated with AKI. A p value < 0.05 was considered statistically significant. Results. The mean age of children with severe malaria was 7.0 ± 3.8 years, and 54.3% of them were male. Of the 350 children enrolled, 167 had AKI, giving an overall AKI prevalence of 47.7% (95% CI: 42.5-53.0). The factors that were significantly associated with AKI among children with severe malaria included caretaker with no formal education ( aOR = 21.0 , 95% CI: 1.68–261.18, p = 0.018 ), caretaker with primary education level ( aOR = 4.5 , 95% CI: 1.41–14.12, p = 0.011 ), age of child < 5 years ( aOR = 1.8 , 95% CI: 1.07–2.88, p = 0.025 ), history of receiving NSAIDs ( aOR = 5.6 , 95% CI: 2.34–13.22, p < 0.001 ), moderate anemia ( aOR = 3.1 , 95% CI: 1.39–6.94, p = 0.006 ), and severe anemia ( aOR = 3.8 , 95% CI: 1.66–8.55, p = 0.002 ). Conclusion. The prevalence of AKI was high among children with severe malaria in Kiryandongo General Hospital. Acute kidney injury among children with severe malaria was associated with low level of education of caretakers, age of children less than 5 years, history of receiving NSAIDs, and anemia. The management of severe malaria should include screening for AKI especially in children under five years of age, anemic, and those who have received NSAIDs.

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“…[5][6][7] Acute kidney injury (AKI) is common but often undiagnosed, in several paediatric diseases. [8][9][10][11][12] Studies have shown that 12-52% of adult patients hospitalised with fUTI develop AKI. [13][14][15] However, no studies are available in children, with only sporadic cases reporting AKI during paediatric fUTI.…”

Section: Introductionmentioning

confidence: 99%

Acute kidney injury in children hospitalised for febrile urinary tract infection

Marzuillo,

Guarino,

Alfiero

et al. 2024

Acta Paediatrica

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AimTo determine (i) prevalence and the risk factors for acute kidney injury (AKI) in children hospitalised for febrile urinary tract infection (fUTI) and (ii) role of AKI as indicator of an underlying VUR. AKI, in fact, is favoured by a reduced nephron mass, often associated to VUR.MethodsThis retrospective Italian multicentre study enrolled children aged 18 years or younger (median age = 0.5 years) discharged with a primary diagnosis of fUTI. AKI was defined using Kidney Disease/Improving Global Outcomes serum creatinine criteria.ResultsOf 849 children hospitalised for fUTI (44.2% females, median age 0.5 years; IQR = 1.8), 124 (14.6%) developed AKI. AKI prevalence rose to 30% in the presence of underlying congenital anomalies of the kidney and urinary tract (CAKUT). The strongest AKI predictors were presence of CAKUT (OR = 7.5; 95%CI: 3.8–15.2; p = 9.4e‐09) and neutrophils levels (OR = 1.13; 95%CI: 1.08–1.2; p = 6.8e‐07).At multiple logistic regression analysis, AKI during fUTI episode was a significant indicator of VUR (OR = 3.4; 95%CI: 1.7–6.9; p = 0.001) despite correction for the diagnostic covariates usually used to assess the risk of VUR after the first fUTI episode. Moreover, AKI showed the best positive likelihood ratio, positive predictive value, negative predictive value and specificity for VUR.ConclusionAKI occurs in 14.6% of children hospitalised for fUTI and is a significant indicator of VUR.

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Acute Kidney Injury in Children with Acute Appendicitis

Cited by 9 publications

References 17 publications

Acute kidney injury in infants hospitalized for viral bronchiolitis

Acute kidney injury in infants hospitalized for viral bronchiolitis

Factors Associated with Acute Kidney Injury among Children with Severe Malaria at Kiryandongo General Hospital, Uganda

Acute kidney injury in children hospitalised for febrile urinary tract infection

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