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Association of kidney function with posterior reversible encephalopathy syndrome in children

Shruti M Shah, Andrew M South

    Clinical Nephrology
    |February 10, 2022
    PubMed

    Insights

    Kidney function markers like BUN and acute kidney injury (AKI) showed minimal association with posterior reversible encephalopathy syndrome (PRES) in children. Further research is needed to clarify the role of kidney function in PRES development.

    Area of Science:

    • Pediatric Nephrology
    • Neurology
    • Critical Care Medicine

    Background:

    • Posterior reversible encephalopathy syndrome (PRES) is a neurological condition with various potential causes.
    • The role of kidney function as a predictor for PRES in pediatric populations requires further investigation.

    Purpose of the Study:

    • To determine if kidney function markers can predict the occurrence of PRES in high-risk children.
    • To assess the association between blood urea nitrogen (BUN), serum creatinine, and acute kidney injury (AKI) with PRES development.

    Main Methods:

    • A case-control study compared 35 children with PRES to 14 controls.
    • Data collected included BUN, serum creatinine, albumin, hemoglobin, estimated glomerular filtration rate, and AKI.
    • Multivariable regression models and receiver operating characteristic (ROC) curves were utilized.

    Main Results:

    • While 29% of patients had AKI and 67% had nephrotoxic medication exposure, neither BUN nor AKI were statistically significant predictors of PRES.
    • The best predictive threshold for BUN (21.6 mg/dL) demonstrated low predictive ability (AUC 0.664).
    • Sensitivity and specificity for predicting PRES were 60.0% and 71.4%, respectively.

    Conclusions:

    • Kidney function appears to be a less significant risk factor for pediatric PRES than previously thought.
    • Larger prospective studies with refined kidney function assessments are necessary to fully elucidate its role in PRES etiology.
    Abstract

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