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Acute Kidney Injury in Hospitalized Children with COVID19

Sanya Chopra1, Abhijeet Saha2, Virendra Kumar1

  • 1Department of Paediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi 110001, India.

Journal of Tropical Pediatrics
|June 3, 2021
PubMed

Insights

Acute kidney injury (AKI) significantly increases mortality risk in children with COVID-19, especially in resource-limited settings. Early kidney replacement therapy is crucial for reducing deaths in these vulnerable pediatric patients.

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.
Abstract

Keywords:
acute kidney injurycoronavirus disease 19resource-limited settingsepsis

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