ESPN 53rd Annual Meeting

ESPN 2021


 
Acute Kidney Injury in pediatric COVID-19 or MIS-C in Dutch hospitalized patients
MIRIAM MOOIJ 1 ANNE VERBEEK 1 EISKE DORRESTEIJN 2 DAVID SLOTBOOM 1 CAROLINE BRACKEL 3 SIMONE HASHIMOTO 3 SUZANNE TERHEGGEN-LAGRO 3 MICHIEL BANNIER 4 MANOUK VAN DER STEEN 4 RIANNE OOSTENBRINK 2 PIETER FRAAIJ 2 NAOMI KETHARANATHAN 2 DENISE ROOK 5 KOEN VAN AERDE 6 RONALD PETRU 6 MARLIES VAN HOUTEN 7 SANNE HAMMER 8 JANTINE BOLT-WIERINGA 9 GERDIEN TRAMPER 10 XANDRA VAN DE TWEEL 11 ANJALI BECHAN-KOOTER 12 JAN VAN DER LINDEN 13 ARVID KAMPS 14 LONNEKE VAN ONZENOORT 15 MARGOT ERNST-KRUIS 16 ANKIE LEBON 17 STEPHANIE DE CROM 18 JOLITHA BEKHOF 19 HAN HENDRIKS 20 WIM TISSING 21 ANNETTE VERNOOIJ 22 INGEBORG BART 23 CARIEN MIEDEMA 24 ANNEMARIE OUDSHOORN 25 BETTINA AUFFARTH 26 YOLANDE THOMASSE 27 MAARTEN RIJPERT 28 JOYCE GORIS 29 MONIQUE JACOBS 30 CHARLIE OBIHARA 31 ERIK VON ASMUTH 1 EMMELINE BUDDINGH 1

1- WILLEM-ALEXANDER KINDERZIEKENHUIS, LUMC
2- ERASMUS MC SOPHIA
3- 3. EMMA KINDERZIEKENHUIS, AMSTERDAM UMC
4- MAASTRICHT UNIVERSITY MEDICAL CENTRE
5- ULIANA KINDERZIEKENHUIS, HAGA ZIEKENHUIS,
6- 7. AMALIA KINDERZIEKENHUIS, RADBOUD UMC
7- SPAARNE GASTHUIS
8- AMPHIA ZIEKENHUIS
9- HAAGLANDEN MEDISCH CENTRUM
10- FRANCISCUS GASTHUIS VLIETLAND
11- MAASSTAD ZIEKENHUIS
12- ALRIJNE ZIEKENHUIS
13- BERNHOVEN
14- MARTINI ZIEKENHUIS
15- MAXIMA MEDISCH CENTRUM
16- MEANDER MEDISCH CENTRUM
17- ALBERT SCHWEIZER ZIEKENHUIS
18- BRAVIS ZIEKENHUIS
19- ISALA KLINIEKEN
20- ZUYDERLAND MEDISCH CENTRUM
21- PRINSES MAXIMA CENTRUM
22- ST JANSDAL
23- CANISIUS WILHELMINA ZIEKENHUIS
24- CATHARINA ZIEKENHUIS
25- GELRE ZIEKENHUIS
26- OMMELANDER ZIEKENHUIS
27- DIJKLANDER ZIEKENHUIS
28- ZAANS MEDISCH CENTRUM
29- ZORGSAAM ZIEKENHUIS
30- SLINGELAND ZIEKENHUIS
31- ELISABETH-TWEESTEDEN ZIEKENHUIS
 
Introduction:

A small but significant proportion of children with COVID-19 or Multisystem Inflammatory Syndrome in Children (MIS-C) is severely ill, therefore we aimed to describe the incidence of Acute Kidney Injury (AKI). 

Material and methods:

This is a multicenter, prospective, ongoing cohort study in 53 hospitals www.covidkids.nl. Children (0-17 years) were included if they presented with COVID-19 in the hospital and had a positive real-time RT-PCR test on SARS-CoV-2 or fulfilled a clinical diagnosis for COVID-19 or MIS-C. Data was collected from April 2020 till April 2021. Patients were excluded from analysis when there were no symptoms attributed to COVID-19 (e.g. screening test positive). AKI was defined and staged according to Kidney Disease: Improving Global Outcomes criteria. Severity of COVID-19 disease was defined as non-severe, moderately severe (need of supplemental oxygen), severe (admitted to ICU), very severe (ECMO or death). Severity of MIS-C disease was defined as non-severe, moderately severe (admitted to ICU), severe (ICU admission with invasive respiratory and/or inotropic support), very severe (ECMO or death). 

Results:

In total 188 subjects were included in the cohort, of which 89 had at least one serum creatinine measurement. 41/89 cases had an acute COVID-19 presentation, 48/89 had MIS-C. Five patients had a nephrological medical history (pyelonephritis [n=2], IgA nephropathy [n=2], renal insufficiency [n=1]). One patient with acute COVID-19 required renal replacement therapy. The incidence of AKI was 29% and 40% in respectively the COVID-19 and the MIS-C group. If we assume that missing cases of creatinine had normal renal function, then the incidence of AKI is respectively 9% (12/132) and 34% (19/56). In our cohort, severity of disease of COVID-19/MIS-C was associated with AKI in the COVID-19 (p=0.015), but not in the MIS-C group (p=0.12). 

Conclusions:

Children with MIS-C or severe COVID-19 had the highest incidence of AKI.