Determinants of Acute Kidney Injury in Children With Nephrotic Syndrome: A Prospective Observational Study DOI Open Access

Nimisha Mohanty,

Anil Kumar Goel, Manas Ranjan Sahoo

et al.

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 3, 2025

Background Nephrotic syndrome (NS) is a common renal ailment among children, typically manifesting as relapsing-remitting pattern. Most of the cases are managed on an outpatient basis, but subset patients experience complications, e.g., acute kidney injury (AKI). Although historically more prevalent in secondary NS, AKI now occurring increasingly children with idiopathic NS. However, literature this population consists case reports and retrospective studies, particularly from India, so study was planned to identify various risk factors that precipitate child The objective assess hydration status having NS its association development AKI. Materials methods This longitudinal conducted Department Pediatrics at All India Institute Medical Sciences, Raipur, Chhattisgarh, October 2021 April 2023. Children both genders age groups between three months 15 years, satisfying International Society for Pediatric Neurosurgery guideline diagnosis were included study. chronic disease excluded. Using non-probability convenient sampling technique, 57 enrolled without evaluated daily using Kidney Disease Improving Global Outcomes 2012 until day 14 or discharge followed up six months. Records those who admitted reviewed possible Data analyzed Epi Info software enUS version 7.3.2 (Centers Control Prevention, Atlanta, GA, USA). Categorical data expressed percentage and/or 95% confidence interval (CI) estimate compared Chi-square Fisher's exact test. A p-value ≤0.05 considered statistically significant. odds ratio (OR) determined logistic regression. Results mean subjects onset 5.34 ± 3.66 years. presentations edema (94.74%) oliguria (80.7%). majority (89.2%) showed response steroid therapy. About 56.14% developed AKI, stages 2 3 common, 37.5% each. 53.12% 46.88% pre-renal intrinsic respectively; 45.61% had hypertension admission, stage 1 (38.46%). Only (10.5%) sickle cell trait, all during follow-up. Forty-two (73.68%) nephrotoxic drug exposure, most being enalapril, by antibiotics. Out 10 underwent biopsy, focal segmental glomerulosclerosis entity (60%). notable parameters found have statistical significance low eGFR hypertension, inadequate water intake, fractional excretion sodium (FeNa), urine potassium index markers hypoperfusion, infections, steroid-resistant nephrotic syndrome, significant glomerular lesions. Conclusion present demonstrates traditional causation high osmolality, raised K+ index, FeNa suggestive aldosterone levels

Language: Английский

Determinants of Acute Kidney Injury in Children With Nephrotic Syndrome: A Prospective Observational Study DOI Open Access

Nimisha Mohanty,

Anil Kumar Goel, Manas Ranjan Sahoo

et al.

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 3, 2025

Background Nephrotic syndrome (NS) is a common renal ailment among children, typically manifesting as relapsing-remitting pattern. Most of the cases are managed on an outpatient basis, but subset patients experience complications, e.g., acute kidney injury (AKI). Although historically more prevalent in secondary NS, AKI now occurring increasingly children with idiopathic NS. However, literature this population consists case reports and retrospective studies, particularly from India, so study was planned to identify various risk factors that precipitate child The objective assess hydration status having NS its association development AKI. Materials methods This longitudinal conducted Department Pediatrics at All India Institute Medical Sciences, Raipur, Chhattisgarh, October 2021 April 2023. Children both genders age groups between three months 15 years, satisfying International Society for Pediatric Neurosurgery guideline diagnosis were included study. chronic disease excluded. Using non-probability convenient sampling technique, 57 enrolled without evaluated daily using Kidney Disease Improving Global Outcomes 2012 until day 14 or discharge followed up six months. Records those who admitted reviewed possible Data analyzed Epi Info software enUS version 7.3.2 (Centers Control Prevention, Atlanta, GA, USA). Categorical data expressed percentage and/or 95% confidence interval (CI) estimate compared Chi-square Fisher's exact test. A p-value ≤0.05 considered statistically significant. odds ratio (OR) determined logistic regression. Results mean subjects onset 5.34 ± 3.66 years. presentations edema (94.74%) oliguria (80.7%). majority (89.2%) showed response steroid therapy. About 56.14% developed AKI, stages 2 3 common, 37.5% each. 53.12% 46.88% pre-renal intrinsic respectively; 45.61% had hypertension admission, stage 1 (38.46%). Only (10.5%) sickle cell trait, all during follow-up. Forty-two (73.68%) nephrotoxic drug exposure, most being enalapril, by antibiotics. Out 10 underwent biopsy, focal segmental glomerulosclerosis entity (60%). notable parameters found have statistical significance low eGFR hypertension, inadequate water intake, fractional excretion sodium (FeNa), urine potassium index markers hypoperfusion, infections, steroid-resistant nephrotic syndrome, significant glomerular lesions. Conclusion present demonstrates traditional causation high osmolality, raised K+ index, FeNa suggestive aldosterone levels

Language: Английский

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