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Cochrane COVID-19 Study Register
Study record
Mohkam 2020First Published: 2022 Nov 23Updated Date: 2022 Nov 23

Acute Kidney Injury in Pediatric Patients with COVID-19

  1. Study Type
  2. Observational
  1. Study Aim
  2. Diagnostic/Prognostic
  1. Study Design
  2. Case series/Case control/Cohort
  1. Intervention Assignment
  2. Not Applicable
Reference record

Acute Kidney Injury in Pediatric Patients with COVID-19

Mohkam M
Journal article
Report Results
In December 2019, outbreak of coronavirus 2019 (COVID-19) disease occurred in Wuhan and rapidly spread to other areas. Nephrologic problems among patients with COVID-19 can manifest as acute kidney injury (AKI), hematuria, or proteinuria and some kind of complications like hypertension. AKI is largely due to hemodynamic changes and cytokine release but somehow due to the direct cytotoxicity of virus or drug nephrotoxicity. Patients with suspected or confrmed COVID-19 may present with different stages of acute kidney injury as part of their overall illness. The incidence of AKI in patients with COVID-19 was about 17 percent (range 0.5 to 80 percent) and approximately 5 percent of patients require renal replacement therapy (RRT). The incidence seems to vary by geographic location and proportion of critically ill patients included in each study. AKI was noted on admission or within 24 hours of admission in one-third of the patients. AKI correlated with severity of illness. For prevention of AKI in hospitalized patients, an emphasis should be placed on optimization of volume status to exclude and treat prerenal azotemia while avoiding hypervolemia, which may worsen the patient's respiratory status. Diferences in management of AKI among patients with COVID-19 may include limited use of intravenous solutions. Most patients with COVID-19 characterized by respiratory problems have variable degree of oxygen requirements and/or airway control. Fluid resuscitation are understandably conservative as per acute respiratory distress syndrome criteria. Thus, fuid resuscitation should be individualized and based on trackable objective measures. The indications for RRT for AKI remain the same indications regardless of the COVID-19 status. Alterations in RRT that might be undertaken during the COVID-19 outbreak include continuous renal replacement therapy (CRRT) which remains preferred among critically ill patients with AKI and hypotension. [This record is from Embase.com and was provided under license by Elsevier. All rights are retained by the license holder.]
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