AKI in Children Hospitalized with Nephrotic Syndrome.

Autor:	Rheault MN; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material. rheau002@umn.edu., Zhang L; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Selewski DT; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Kallash M; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Tran CL; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Seamon M; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Katsoufis C; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Ashoor I; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Hernandez J; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Supe-Markovina K; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., D'Alessandri-Silva C; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., DeJesus-Gonzalez N; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Vasylyeva TL; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Formeck C; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Woll C; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Gbadegesin R; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Geier P; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Devarajan P; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Carpenter SL; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Kerlin BA; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material., Smoyer WE; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
Jazyk:	angličtina
Zdroj:	Clinical journal of the American Society of Nephrology : CJASN [Clin J Am Soc Nephrol] 2015 Dec 07; Vol. 10 (12), pp. 2110-8. Date of Electronic Publication: 2015 Oct 08.
DOI:	10.2215/CJN.06620615
Abstrakt:	Background and Objectives: Children with nephrotic syndrome can develop life-threatening complications, including infection and thrombosis. While AKI is associated with adverse outcomes in hospitalized children, little is known about the epidemiology of AKI in children with nephrotic syndrome. The main objectives of this study were to determine the incidence, epidemiology, and hospital outcomes associated with AKI in a modern cohort of children hospitalized with nephrotic syndrome. Design, Setting, Participants, & Measurements: Records of children with nephrotic syndrome admitted to 17 pediatric nephrology centers across North America from 2010 to 2012 were reviewed. AKI was classified using the pediatric RIFLE definition. Results: AKI occurred in 58.6% of 336 children and 50.9% of 615 hospitalizations (27.3% in stage R, 17.2% in stage I, and 6.3% in stage F). After adjustment for race, sex, age at admission, and clinical diagnosis, infection (odds ratio, 2.24; 95% confidence interval, 1.37 to 3.65; P=0.001), nephrotoxic medication exposure (odds ratio, 1.35; 95% confidence interval, 1.11 to 1.64; P=0.002), days of nephrotoxic medication exposure (odds ratio, 1.10; 95% confidence interval, 1.05 to 1.15; P<0.001), and intensity of medication exposure (odds ratio, 1.34; 95% confidence interval, 1.09 to 1.65; P=0.01) remained significantly associated with AKI in children with nephrotic syndrome. Nephrotoxic medication exposure was common in this population, and each additional nephrotoxic medication received during a hospitalization was associated with 38% higher risk of AKI. AKI was associated with longer hospital stay after adjustment for race, sex, age at admission, clinical diagnosis, and infection (difference, 0.45 [log]days; 95% confidence interval, 0.36 to 0.53 [log]days; P<0.001). Conclusions: AKI is common in children hospitalized with nephrotic syndrome and should be deemed the third major complication of nephrotic syndrome in children in addition to infection and venous thromboembolism. Risk factors for AKI include steroid-resistant nephrotic syndrome, infection, and nephrotoxic medication exposure. Children with AKI have longer hospital lengths of stay and increased need for intensive care unit admission. (Copyright © 2015 by the American Society of Nephrology.)
Databáze:	MEDLINE
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