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Acute kidney injury, children

Judith Sebestyen VanSickle, Tarak Srivastava, Uri S Alon
Background . Hemolytic uremic syndrome (HUS) is one of the common causes for acute kidney injury in childhood. Objective . The goals of our study were to identify risk factors for short-term complications and long-term outcomes of chronic kidney disease (CKD) in Shiga toxin-producing Escherichia coli (STEC)-HUS and other diarrhea positive (D+ ) HUS. Methods . Retrospective chart review was obtained of 58 pediatric patients treated for STEC-HUS and other D+ HUS between February 2002 and January 2011. Results ...
2018: Global Pediatric Health
Francesco Garzotto, Marta Zaccaria, Enrico Vidal, Zaccaria Ricci, Anna Lorenzin, Mauro Neri, Luisa Murer, Federico Nalesso, Alfredo Ruggeri, Claudio Ronco
OBJECTIVES: Renal replacement therapy in infants and small children is the treatment of choice for severe oligoanuric renal dysfunction, with an increasing consensus that early initiation might contribute to preventing acute kidney injury complications. Safer renal replacement therapy devices specifically designed for neonates may contribute to ameliorating outcomes and increasing chances of survival. One of the crucial factors to achieve an effective renal replacement therapy in small infants is adequate vascular access...
December 7, 2018: Pediatric Critical Care Medicine
Kevin T Barton, Aadil Kakajiwala, Dennis J Dietzen, Charles W Goss, Hongjie Gu, Vikas R Dharnidharka
Beta-2-microglobulin (B2M) is a marker of proximal tubular injury and glomerular filtration. Analyses using older/non-standardized definitions have shown low efficacy of B2M to predict acute kidney injury (AKI). We assessed if elevated levels of B2M would associate with either the diagnosis of AKI [under current Kidney Disease: Improving Global Outcomes (KDIGO) criteria] or recovery from AKI. We performed a retrospective study, including children who had urine B2M (uB2M) and/or serum B2M (sB2M) measured by immunoturbidimetry in our clinical laboratory between January 2011 and December 2015...
December 2018: Clinical Kidney Journal
Jennifer H Foster, Patrick A Thompson, M Brooke Bernhardt, Judith F Margolin, Susan G Hilsenbeck, Eunji Jo, Deborah A Marquez-Do, Michael E Scheurer, Eric S Schafer
PURPOSE: High-dose methotrexate (HDMTX) is critical to the successful treatment of pediatric acute lymphoblastic leukemia (ALL) but can cause significant toxicities. This study prospectively evaluated the effectiveness of a fixed algorithm which requires no real-time pharmacokinetic modeling and no previous patient exposure to HDMTX, to individualize HDMTX dosing for at-risk patients with the aim of avoiding methotrexate-related toxicities. METHODS: We developed a simple algorithm to individualize HDMTX infusions with 0-2 rate adjustments based on methotrexate levels during the infusion...
November 28, 2018: Cancer Chemotherapy and Pharmacology
Monika Miklaszewska, Przemysław Korohoda, Katarzyna Zachwieja, Alina Sobczak, Krzysztof Kobylarz, Constantinos J Stefanidis, Jolanta Goździk, Dorota Drożdż
BACKGROUND: Acute kidney injury (AKI) occurs in up to 30% of pediatric intensive care unit (PICU) patients and is associated with a high mortality rate. OBJECTIVES: The objective of the study was to evaluate factors associated with the outcome and to identify the prognostic factors in children receiving continuous renal replacement therapy (CRRT). MATERIAL AND METHODS: This was a retrospective, single-center study, including 46 patients. RESULTS: Logistic regression analysis demonstrated significant effects on patient survival exerted by the percentage of fluid overload (FO%) (odds ratio (OR): 1...
November 21, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Yao Xu, Yang Fang Wu, Huang Huang Luo, Dong Dong Zhang, Yue Wu, Peng Hu
Hand, foot and mouth disease (HFMD) is a common infectious disease among children, caused primarily by human enterovirus-A71 (EV-A71) and coxsackievirus-A16 (CV-A16). To date, only two case reports mention that renal involvement can be secondary to or coexisting with CV-A16-associated HFMD. In the present report, we describe a 10-year-old girl who was infected with EV-A71 and subsequently developed a definite acute kidney injury (AKI), mainly based on the characteristic rash, virus isolation, eyelid edema, hypertension, decreased urine output, mild proteinuria and impaired renal function...
November 19, 2018: Journal of Tropical Pediatrics
Rebecca L Ruebner, Jeffrey J Fadrowski
Tubulointerstitial nephritis (TIN) is a cause of acute kidney injury in children characterized histologically by an inflammatory cell infiltrate in the kidney interstitium. The most common causes of TIN in children include medications, infections, inflammatory disorders, and genetic conditions. TIN typically presents with nonoliguric acute kidney injury and may be associated with systemic symptoms, including fever, rash, and eosinophilia. The long-term prognosis is generally favorable, with full kidney recovery; however, some patients may develop progressive chronic kidney disease...
February 2019: Pediatric Clinics of North America
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
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at
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 characterized by abrupt deterioration of renal function, and its diagnosis relies on creatinine measurements and urine output. AKI is associated with higher morbidity and mortality, and is a risk factor for development of chronic kidney disease. There is no proven medication for AKI. Therefore, prevention and early detection are important. Physicians should be aware of the risk factors for AKI and should monitor renal function in high-risk patients. Management of AKI includes optimization of volume status and renal perfusion, avoidance of nephrotoxic agents, and sufficient nutritional support...
November 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
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