Acute Kidney Injury in Hospitalized Children with COVID19

Area of Science:

• Pediatric Nephrology
• Infectious Diseases
• Critical Care Medicine

Background:

• Acute kidney injury (AKI) is a known risk factor for mortality in adults with severe acute respiratory syndrome coronavirus infection.
• Limited data exists on AKI prevalence and risk factors in pediatric COVID-19 patients, particularly in resource-limited settings.

Purpose of the Study:

• To determine the prevalence and identify risk factors for AKI in hospitalized children with COVID-19.
• To assess the impact of AKI on mortality in this pediatric population within a resource-limited environment.

Main Methods:

• A cross-sectional analysis of laboratory-confirmed COVID-19 pediatric cases admitted between March and November 2020.
• AKI staging was performed using the Kidney Disease Improving Global Outcomes (KDIGO) serum creatinine criteria.
• Univariate and Kaplan-Meier survival analyses were employed to evaluate outcomes.

Main Results:

• Of 105 hospitalized children, 22.8% developed AKI, with 37.5% in Stage 3.
• Risk factors for AKI included sepsis, nephrotic syndrome, vasopressor support, shock, and mechanical ventilation.
• Mortality was significantly higher in the AKI group (25.71%), with shock and ventilation being major contributors.

Conclusions:

• AKI is a critical, modifiable risk factor for mortality in pediatric COVID-19 patients in resource-limited settings.
• Strengthening kidney replacement therapy and ensuring its timely initiation are vital for improving survival rates.