Turkish Archives of Pediatrics
Original Article

Kidney Involvement in Pediatric COVID-19 Cases: A Single-Center Experience

1.

Department of Pediatric Nephrology, University of Health Sciences, Haseki Training and Research Hospital, İstanbul, Turkey

2.

Department of Pediatric Nephrology, İstanbul University -Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey

3.

Department of Pediatric Infectious Diseases, University of Health Sciences, Haseki Training and Research Hospital, İstanbul, Turkey

4.

Department of Pediatrics, University of Health Sciences, Haseki Training and Research Hospital, İstanbul, Turkey

5.

Department of Biochemistry, University of Health Sciences, Haseki Training and Research Hospital, İstanbul, Turkey

6.

Department of Pediatric Endocrinology, University of Health Sciences, Haseki Training and Research Hospital, İstanbul, Turkey

7.

Department of Pediatric Endocrinology, İstanbul University -Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey

Turk Arch Pediatr 2022; 57: 558-562
DOI: 10.5152/TurkArchPediatr.2022.22012
Read: 170 Downloads: 95 Published: 01 September 2022

Objective: The kidney is the second most commonly affected organ by severe acute respiratory syndrome coronavirus-2, characterized by hematuria, proteinuria, and acute kidney injury. There are few studies describing renal involvement in pediatric cases.

Materials and Methods: This retrospective study evaluated the prevalence of hematuria, proteinuria, and acute kidney injury in severe acute respiratory syndrome coronavirus-2-positive pediatric cases (1-18 years old) who visited emergency department between March and November 2020. Patients with urinary tract infections were excluded. An age-specific upper limit of reference interval was used to define “elevated serum creatinine” (greater than upper limit of reference interval) and acute kidney injury (>1.5 times upper limit of reference interval).

Results: A total of 228 patients were evaluated, median age was 12.7 years (interquartile range: 7.5; 16.1), and 51.3% were male. The prevalence of asymptomatic, mild, and moderate-to-severe disease was 12.7% (29/228), 77.2% (176/228), and 10.1% (23/228), respectively. The prevalence of hematuria, proteinuria, and elevated serum creatinine was 15.8% (36/228), 6% (14/228), and 3% (7/228), respectively. Kidney involvement (i.e., at least 1 of these findings) was 23.2% (53/228) and significantly higher in the moderate-to-severe disease (43.5%). None of the patients met the acute kidney injury criterion. In logistic regression analysis, female sex (odds ratio: 1.97, 95 CI%: 1.03; 3.70, P = .040) and fever (odds ratio: 2.28, 95% CI: 1.19; 4.36, P = .012) were independent predictors of kidney involvement. Three patients demonstrated a kidney presentation (macroscopic hematuria) on admission, and another patient was diagnosed with C3 glomerulonephritis during hospitalization.

Conclusion: Kidney involvement was found about in 1 quarter of children with coronavirus disease 2019. Awareness and recognition of kidney involvement and follow-up are important in the management.

Cite this article as: Ağbaş A, Akkoç G, Kızılırmak C, Çalışkan Dolu N, Bayramoğlu E, Elevli M. Kidney involvement in pediatric COVID-19 cases: A single-center experience. Turk Arch Pediatr. 2022;57(5):558-562.

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