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AKI in COVID-19-Associated Multisystem Inflammatory Syndrome in Children (MIS-C)
Marissa Lipton1, Ruchi Mahajan1, Catherine Kavanagh1
1Division of Pediatric Nephrology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York.
Kidney360
|April 4, 2022
Summary
Most children with multisystem inflammatory syndrome in children (MIS-C) develop acute kidney injury (AKI) that is mild and resolves quickly. Older age and inflammation are potential risk factors for AKI in MIS-C.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Critical Care Medicine
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a novel condition linked to COVID-19.
- Acute kidney injury (AKI) is common in COVID-19 but understudied in MIS-C.
- This study characterizes AKI in a pediatric MIS-C cohort during the COVID-19 pandemic.
Purpose of the Study:
- To investigate the incidence and characteristics of AKI in children diagnosed with MIS-C.
- To identify potential risk factors associated with AKI development in MIS-C patients.
- To compare renal injury patterns in MIS-C with those in primary COVID-19 infection.
Main Methods:
- Retrospective cohort study of 57 children (0-20 years) meeting CDC MIS-C criteria.
- Evaluation for AKI presence and staging using KDIGO criteria.
- Analysis of clinical data, inflammatory markers, and cardiac function.
Main Results:
- 46% of MIS-C patients developed AKI, mostly KDIGO stage 1 (58%).
- AKI was present on admission in 70% of affected children.
- Older age, elevated CRP, IL-6, ferritin, procalcitonin, left ventricular systolic dysfunction, and lymphopenia were associated with AKI.
Conclusions:
- Pediatric MIS-C can be associated with AKI, typically mild with good prognosis.
- Risk factors for AKI in MIS-C include older age, heightened inflammation, and cardiac dysfunction.
- AKI in MIS-C differs significantly in epidemiology and outcomes from AKI in primary COVID-19.
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