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acute kidney injury in children

Hrafnhildur Linnet Runolfsdottir, Runolfur Palsson, Inger MSch Agustsdottir, Olafur S Indridason, Vidar O Edvardsson
BACKGROUND: Adenine phosphoribosyltransferase (APRT) deficiency is a hereditary purine metabolism disorder that causes kidney stones and chronic kidney disease (CKD). The purpose of this study was to examine the course of APRT deficiency in patients who presented in childhood. METHODS: The disease course of 21 (35%) patients in the APRT Deficiency Registry of the Rare Kidney Stone Consortium, who presented with manifestations of APRT deficiency and/or were diagnosed with the disorder before the age of 18 years, was studied...
November 15, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Gerard Cortina, Rosemary McRae, Monsurul Hoq, Susan Donath, Roberto Chiletti, Marjan Arvandi, Raffaella M Gothe, Michael Joannidis, Warwick Butt
OBJECTIVE: To identify risk factors associated with mortality in critically ill children requiring continuous renal replacement therapy. DESIGN: Retrospective observational study based on a prospective registry. SETTING: Tertiary and quaternary referral 30-bed PICU. PATIENTS: Critically ill children undergoing continuous renal replacement therapy were included in the study. INTERVENTIONS: Continuous renal replacement therapy...
November 13, 2018: Pediatric Critical Care Medicine
Jing He, Guoyan Xie, Hui Wu, Song Xu, Jun Xie, Youyuan Chen, Xinqian Zhao
In this study, we investigated the association of 12 polymorphisms in six inflammatory-response genes ( TNF, IL6, IL10, IL18, NFKB1 and NFKBIA ) with risk of acute kidney injury (AKI) in children. The polymorphisms were genotyped in 1138 children with AKI and 1382 non-AKI controls. Logistic regression analysis was performed to calculate the odds ratio for estimating the risk association. After accounting for Bonferroni correction and adjustment for potential confounders, significant association was observed for NFKB1 rs28362491, NFKBIA rs2233406 and NFKBIA rs696 polymorphisms (P < 0...
November 14, 2018: Bioscience Reports
Yichun Cheng, Sheng Nie, Lu Li, Yanqin Li, Diankun Liu, Mengqi Xiong, Long Wang, Shuwang Ge, Gang Xu
Acute kidney injury (AKI) is a common complication in cancer patients, but the data are lacking in Asian countries. We aimed to assed the epidemiology, correlated risk factors and outcomes of AKI in cancer patients from China. We conducted a nationwide cohort study of cancer patients who were admitted to 25 general and children hospitals across China from January 1, 2013 to December 31, 2015. We obtained patient-level data from the electronic hospitalization information system and laboratory databases of all inpatients who had at least two serum creatinine tests within any 7-day window during their first 30 days of hospitalization...
November 13, 2018: International Journal of Cancer. Journal International du Cancer
Katsuaki Kasahara, Yoshimitsu Gotoh, Yoshiyuki Kuroyanagi, China Nagano, Satoshi Yamakawa, Kazuki Tanaka, Asami Takeda, Osamu Uemura
BACKGROUND: The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines suggest initially using angiotensin-converting-enzyme inhibitors (ACE-Is) and/or angiotensin receptor blockers (ARBs) to treat Henoch-Schönlein purpura nephritis (HSPN). However, these guidelines might overlook the potential benefits of aggressive therapy. Therefore, we evaluated the efficacy of an HSPN protocol that primarily uses steroids and immunosuppressants, without ACE-Is or ARBs. METHODS: We determine treatment intensity based on International Study of Kidney Diseases in Children (ISKDC) grading...
November 7, 2018: Minerva Pediatrica
Alaleh Gheissari, Nahid Aslani, Azadeh Eshraghi, Masoud Moslehi, Alireza Merikhi, Mojtaba Keikhah, Shaghayegh Haghjoo Javanmard, Golnaz Vaseghi
BACKGROUND: Urinary tract infection and pyelonephritis are clinical problems that frequently occur in children. Several factors are responsible for renal tissue injury, morbidity, and renal scarring after pyelonephritis. The aim of this study was to evaluate the preventive effect of L-carnitine on renal scarring in acute pyelonephritis. METHODS: A randomized double-blind clinical trial was conducted on 65 children aged 6 months to 10 years. Patients were randomized into 2 groups to receive 7-day treatment with only antibiotics without L-carnitine (control group; n = 32) and 7-day treatment with L-carnitine (case group; n = 33) during the acute phase of infection...
October 24, 2018: American Journal of Therapeutics
Zhiyong Zhang, Ya Gao, Ximin Qiao
Spleen tyrosine kinase (SYK), which is a non-receptor protein tyrosine kinase, has been reported to be connected to the cells survival. Especially, SYK is demonstrated to have protective effect on B cells against the injury induced by the anoxia/hypoglycemia (A/H) condition. However, the role of SYK in the renal cells exposed to the A/H injury is still unclear currently. In our study, we aimed to explore the role and the molecular mechanism of SYK in renal cells with A/H injury. We found that the mRNA and protein expressions of SYK were significantly increased in the human proximal tubular epithelial cell HK-2 with the treatment of A/H injury...
November 5, 2018: Gene
Guo-Huang Hu, Lian Duan, Meng Jiang, Cheng-Liang Zhang, Yan-Ying Duan
OBJECTIVE: The association between poor intraoperative glycemic control and postoperative acute kidney injury (AKI) in adult cardiac surgery has been observed, but data in the pediatrics remain unknown. We performed a hypothesis that intraoperative hyperglycemia and/or wider glycemic fluctuation were associated with the incidence of postoperative AKI in pediatric cardiac surgery. METHODS: A retrospective study was performed in pediatrics who underwent cardiac surgery from 2013 to 2016...
November 2018: Renal Failure
Amanda M Uber, Scott M Sutherland
Over the past decade, the nephrology and critical care communities have adopted a consensus approach to diagnosing acute kidney injury (AKI) and, as a result, we have seen transformative changes in our understanding of pediatric AKI epidemiology. The data regarding outcomes among neonates and children who develop AKI have become far more robust and AKI has been clearly linked with an increased need for mechanical ventilation, longer inpatient stays, and higher mortality. Though AKI was historically thought to be self-limited, we now know that renal recovery is far from universal, particularly when AKI is severe; the absence of recovery from AKI also carries longitudinal prognostic implications...
November 1, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Catherine Monet-Didailler, Astrid Godron-Dubrasquet, Iona Madden, Yahsou Delmas, Brigitte Llanas, Jérôme Harambat
BACKGROUND: Hemolytic uremic syndrome due to Shiga toxin-producing E. coli (STEC-HUS) is the main cause of acute kidney injury in young children. Most fully recover kidney function; however, some develop long-term sequelae. We aimed to determine whether kidney injury 1 year after HUS onset is associated with long-term kidney outcome in pediatric STEC-HUS. METHODS: A retrospective population-based study of children < 15 years with STEC-HUS between 1992 and 2012 was performed...
October 27, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Paolo Giordano, Giuseppe Stefano Netti, Luisa Santangelo, Giuseppe Castellano, Vincenza Carbone, Diletta Domenica Torres, Marida Martino, Michela Sesta, Franca Di Cuonzo, Maria Chiara Resta, Alberto Gaeta, Leonardo Milella, Maria Chironna, Cinzia Germinario, Gaia Scavia, Loreto Gesualdo, Mario Giordano
BACKGROUND: Thrombotic microangiopathy (TMA) is a clinical syndrome encompassing a large group of rare but severe disorders including thrombotic thrombocytopenic purpura (TTP) and both typical and atypical forms of hemolytic uremic syndrome (HUS). The key role of the complement system is well known in TTP and atypical HUS, but recent reports describe its involvement in the pathogenesis of HUS secondary to gastrointestinal infections due to Shiga toxin-producing Escherichia coli (STEC)...
October 25, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Myung Hyun Cho, Hee Gyung Kang
Acute kidney injury (AKI) is abrupt deterioration of renal function, and its diagnosis relies upon creatinine measurements and urine output. AKI is associated with higher morbidity and mortality, and is a risk factor of development of chronic kidney disease. There is no proven medication for AKI. Therefore prevention and early detection are important. Physicians need to be aware of the risk factors for AKI, and monitor renal function in high risk patients. AKI management includes optimization of volume status and renal perfusion, avoidance of nephrotoxic agents, and sufficient nutritional support...
October 23, 2018: Korean Journal of Pediatrics
Avichai Weissbach, Noy Zur, Eytan Kaplan, Gili Kadmon, Yulia Gendler, Elhanan Nahum
OBJECTIVES: Acute kidney injury in the critically ill pediatric population is associated with worse outcome. The aim of this study was to assess the prevalence, associated clinical variables, and outcomes of acute kidney injury in children admitted to the PICU with diabetic ketoacidosis. DESIGN: Retrospective cohort. SETTING: PICU of a tertiary, university affiliated, pediatric medical center. PATIENTS: All children less than age 18 years with a primary diagnosis of diabetic ketoacidosis admitted to the PICU between November 2004 and October 2017...
October 24, 2018: Pediatric Critical Care Medicine
Doralina L Anghelescu, Christina-Lin Brown, Andrew J Murphy, Andrew M Davidoff, Paxton V Dickson, Evan S Glazer, Zachary E Stiles, Michael W Bishop, Luke Douthitt, Jeremiah L Deneve
BACKGROUND: Desmoplastic small round cell tumor (DSRCT) is a rare, aggressive sarcoma. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) may improve survival. METHODS: A retrospective review of anesthetic management and postoperative pain control strategies after CRS/HIPEC for DSRCT from 2013 to 2017 was performed. RESULTS: The review analyzed 10 CRS/HIPEC procedures performed for nine DSRCT patients with a median age of 19 years (range 10-24 years)...
October 23, 2018: Annals of Surgical Oncology
Karin Amrein, Alja Papinutti, Erwin Mathew, Greisa Vila, Dhruv Parekh
The prevalence of vitamin D deficiency in intensive care units ranges typically between 40 and 70 %. There are many reasons for being or becoming deficient in the ICU. Hepatic, parathyroid and renal dysfunction aditionally increase the risk for developing vitamin D deficiency. Moreover, therapeutic interventions like fluid resuscitation, dialysis, surgery, extracorporeal membrane oxygenation, cardiopulmonary bypass and plasma exchange may significantly reduce vitamin D levels. Many observational studies have consistently shown an association between low vitamin D levels and poor clinical outcomes in critically ill adults and children, including excess mortality and morbidity such as acute kidney injury, acute respiratory failure, duration of mechanical ventilation and sepsis...
October 1, 2018: Endocrine Connections
Paloma Cañete, Andrés Fernández, Ana Solís, Jimena Del Castillo, Sarah Fernández, Jesús López-Herce
BACKGROUND/AIMS: The incidence of acute kidney injury (AKI) after cardiac arrest (CA) in adults is associated with a high mortality, but there are few data about the incidence and prognosis of AKI after CA in children. The aim of our study was to analyze the incidence of AKI in children who have experienced an in-hospital CA and its association with mortality. METHODS: A retrospective observational study in a prospective database was performed including children between the ages 1 month and 16 years, who had undergone an in-hospital CA...
October 19, 2018: Nephron
Vijitha Burra, P S Nagaraja, Naveen G Singh, V Prabhakar, N Manjunatha
Background: Acute kidney injury (AKI) is a strong predictor of morbidity and mortality after cardiac surgery. Lack of valid early biomarkers for predicting AKI has hampered the ability to take therapeutic measures for preventive cause. Hyperphosphatemia that occurs in AKI due to renal excretion defect was not studied in this context and could be simple marker of AKI. Therefore, we tested role of serum phosphorus in prediction of AKI as a biomarker after cardiac surgery in children. Methodology: We prospectively evaluated 51 children aged between 3 weeks and 12 years undergoing elective cardiac surgery...
October 2018: Annals of Cardiac Anaesthesia
Matthew F Barhight, Danielle Soranno, Sarah Faubel, Katja M Gist
Children who undergo cardiac surgery with cardiopulmonary bypass are a unique population at high risk for postoperative acute kidney injury (AKI) and fluid overload. Fluid management is important in the postoperative care of these children as fluid overload is associated with increased morbidity and mortality. Peritoneal dialysis catheters are an important tool in the armamentarium of a cardiac intensivist and are used for passive drainage for fluid removal or dialysis for electrolyte and uremia control in AKI...
November 2018: World Journal for Pediatric & Congenital Heart Surgery
Marie-Michèle Gaudreault-Tremblay, Catherine Litalien, Natalie Patey, Aicha Merouani
Rationale: Acute tubulointerstitial nephritis (ATIN) in children is most commonly due to allergic drug reactions. In neonates, diagnosis of ATIN is clinically suspected and a kidney biopsy is not routinely performed. Presenting concern: A 17-day-old newborn presented with vomiting and dehydration, along with anuric acute kidney injury, severe electrolyte disturbances, hypocomplementemia, and thrombocytopenia. Abdominal ultrasound revealed bilateral nephromegaly and hepatosplenomegaly...
2018: Canadian Journal of Kidney Health and Disease
Fang Fang, Xiaohan Hu, Xiaomei Dai, Sanfeng Wang, Zhenjiang Bai, Jiao Chen, Jian Pan, Xiaozhong Li, Jian Wang, Yanhong Li
BACKGROUND: Research on acute kidney injury (AKI) has focused on identifying early biomarkers. However, whether AKI could be diagnosed in the absence of the classic signs of clinical AKI and whether the condition of subclinical AKI, identified by damage or functional biomarkers in the absence of oliguria or increased serum creatinine (sCr) levels, is clinically significant remains to be elucidated in critically ill children. The aims of the study were to investigate the associations between urinary cystatin C (uCysC) levels and AKI and mortality and to determine whether uCysC-positive subclinical AKI is associated with adverse outcomes in critically ill neonates and children...
October 10, 2018: Critical Care: the Official Journal of the Critical Care Forum
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