Risk factors and renal outcomes of AKI in children with secondary steroid-resistant nephrotic syndrome

• Published in: Renal failure 2024-12, Vol.46 (1), p.2314637-2314637
• Main Authors: Yu, Nannan, Ouyang, XiaoJun, Li, Jie, Gao, Jie, Zeng, Shuhan, Zhuang, Hongjie, Jiang, Mengjie, Pei, Yuxin, Jiang, Xiaoyun
• Format: Article
• Language: English
• Subjects: acute kidney injury; Age; Children; Confidence intervals; End-stage renal disease; Hospitalization; Kidney diseases; Nephrotic syndrome; outcome; Risk factors; Secondary steroid-resistant nephrotic syndrome; Steroids; Uric acid
• ISSN: 0886-022X; 1525-6049
• DOI: 10.1080/0886022X.2024.2314637

Acute kidney injury (AKI) is increasingly prevalent in children with nephrotic syndrome (NS). It is associated with adverse outcomes in NS, especially steroid-resistant nephrotic syndrome (SRNS). The incidence, risk factors and outcomes of AKI in secondary SRNS remain undefined. The main objectives of this study were to determine the risk factors and prognosis of AKI in hospitalized children with secondary SRNS. This retrospective study was conducted from January 2014 to December 2019, involving 172 hospitalizations with secondary SRNS admitted to the First Affiliated Hospital of Sun Yat-sen University. AKI was defined and classified in accordance with the 2012 Kidney Disease Improving Global Outcomes (KDIGO) guidelines. AKI was found in 67 (39.0%) of 172 hospitalizations with secondary SRNS. Average age of onset in our group is 4.4 (3.1, 6.7) years with AKI and 3.7 (1.8, 5.6) years without AKI. Urea nitrogen level is 5.9 (4.1, 10.0) mmol/L with AKI and 5.1 (3.7, 7.0) mmol/L. Uric acid level is 446.0 (340.0, 567.0) umol/L with AKI and 401.0 (303.0, 496.0) umol/L. 24-h urinary protein level is 4.14 (2.9, 6.5) g with AKI and 2.5 (1.3, 5.3) without AKI. Multivariate logistic regression revealed that infection (  = 5.287; 95% confidence interval, 2.349 to 11.899;