Acute kidney injury in childhood-onset nephrotic syndrome: Incidence and risk factors in hospitalized patients.
- Author:
Mi Young KIM
1
;
Myung Hyun CHO
;
Ji Hyun KIM
;
Yo Han AHN
;
Hyun Jin CHOI
;
Il Soo HA
;
Hae Il CHEONG
;
Hee Gyung KANG
Author Information
- Publication Type:Original Article
- Keywords: Acute kidney injury; Child; Methylprednisolone; Nephrotic syndrome
- MeSH: Acute Kidney Injury*; Child; Cyclosporine; Dehydration; Hospitalization; Humans; Incidence*; Kidney Diseases; Korea; Methylprednisolone; Necrosis; Nephritis, Interstitial; Nephrotic Syndrome*; Renin-Angiotensin System; Retrospective Studies; Risk Factors*
- From:Kidney Research and Clinical Practice 2018;37(4):347-355
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Nephrotic syndrome (NS) is the most common glomerulopathy in children. Acute kidney injury (AKI) is a common complication of NS, caused by severe intravascular volume depletion, acute tubular necrosis, interstitial nephritis, or progression of NS. However, the incidence and risk factors of childhood-onset NS in Korea are unclear. Therefore, we studied the incidence, causes, and risk factors of AKI in hospitalized Korean patients with childhood-onset NS. METHODS: We conducted a retrospective review of patients with childhood-onset NS who were admitted to our center from January 2015 to July 2017. Patients with decreased renal function or hereditary/secondary NS, as well as those admitted for management of other conditions unrelated to NS, were excluded. RESULTS: During the study period, 65 patients with idiopathic, childhood-onset NS were hospitalized 90 times for management of NS or its complications. Of these 90 cases, 29 met the Kidney Disease Improving Global Outcomes criteria for AKI (32.2%). They developed AKI in association with infection (n = 12), NS aggravation (n = 11), dehydration (n = 3), and intravenous methylprednisolone administration (n = 3). Age ≥ 9 years at admission and combined use of cyclosporine and renin-angiotensin system inhibitors were risk factors for AKI. CONCLUSION: AKI occurred in one-third of the total hospitalizations related to childhood-onset NS, owing to infection, aggravation of NS, dehydration, and possibly high-dose methylprednisolone treatment. Age at admission and use of nephrotoxic agents were associated with AKI. As the AKI incidence is high, AKI should be considered during management of high-risk patients.
