Lower albumin level and longer disease duration are risk factors of acute kidney injury in hospitalized children with nephrotic syndrome

Eun Mi Yang, Kee Hwan Yoo, Yo Han Ahn, Seong Heon Kim, Jung Won Lee, Woo Yeong Chung, Min Hyun Cho, Kee Hyuck Kim, Heeyeon Cho, Mee Jeong Lee, Jin Soon Suh, Hye Sun Hyun, Jiwon M. Lee, Myung Hyun Cho, Ji Hyun Kim, Il Soo Ha, Hae Il Cheong, Hee Gyung Kang

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: Children with nephrotic syndrome (NS) are at an increased risk of acute kidney injury (AKI) and the incidence of AKI in this population is reportedly increasing. This study aimed to investigate the incidence, clinical profiles, and risk factors of AKI in hospitalized children with NS through a nationwide study. Methods: This retrospective multicenter study included 14 pediatric nephrology centers in Korea. From 2013 to 2017, a total of 814 patients with idiopathic NS were cared for at participating centers. Among them, 363 patients were hospitalized for NS and investigated in this study. Results: A total of 363 children with NS were hospitalized 574 times. AKI occurred in 93 admissions (16.2%) of 89 patients: 30 (32.3%) stage 1; 24 (25.8%) stage 2; and 39 (41.9%) stage 3. Multivariate logistic regression analysis showed that longer disease duration, lower albumin level, and methylprednisolone pulse treatment were significantly associated with AKI development in hospitalized children with NS. AKI was associated with a longer hospital stay than non-AKI (median 10 vs. 7 days, P = 0.001). Among 93 admissions, 85 (91.4%) episodes recovered from AKI without complication, whereas 6 (6.5%) progressed to advanced chronic kidney disease (CKD). Conclusions: AKI is not uncommon in hospitalized children with NS, and its incidence in this nationwide study was 16.2%. Risk factors for AKI in hospitalized children with NS include longer disease duration, lower albumin level, and methylprednisolone pulse therapy. Pediatric NS patients with these characteristics should be under more strict scrutiny for the occurrence of AKI. [Figure not available: see fulltext.]

Original languageEnglish
Pages (from-to)701-709
Number of pages9
JournalPediatric Nephrology
Volume36
Issue number3
DOIs
StatePublished - Mar 2021

Bibliographical note

Publisher Copyright:
© 2020, IPNA.

Keywords

  • Acute kidney injury
  • Children
  • Hospitalization
  • Nephrotic syndrome
  • Risk factors

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