فهرست مطالب mahbubeh mirzaee

Renal disorders have been reported as the underlying cause as well as complications of critical COVID-19 in pediatric patients. The purpose of this study was to investigate the pattern of kidney involvement, particularly acute kidney injury (AKI), among pediatric patients with COVID-19.

  In this prospective study, hospitalized pediatric patients with a clinical diagnosis of COVID-19 were enrolled. Demographic, clinical, and laboratory findings were collected and analyzed using a mixed method of qualitative and quantitative approaches and descriptive statistics.

  One hundred and eighty-seven patients, including 120 (64.2%) males and 67 (35.8%) females with COVID-19 with a median age (interquartile range) of 60 (24 to 114) months were enrolled in this study. Most patients (n = 108, 58.1%) had one or two underlying comorbidities, mainly malnutrition (77.4%), neurologic/learning disorders (21.4%), and malignancy (10.2%). According to the Kidney Disease Improving Global Outcomes (KDIGO) classification, AKI was detected in 38.5% of patients (stage 1: 55.6%, stage 2: 36.1%, and stage 3: 8.3%) at presentation or during hospitalization. Nine patients (4.8%) required hemodialysis and 16 (8.6%) eventually died. There was no significant association between AKI and admission to the pediatric intensive care unit (PICU) (P > .05), a multisystem inflammatory syndrome in children (MIS-C) (P > .05), comorbidities (P > .05), and mortality rate (P > .05).

Conclusion:

  Kidneys are among the major organs affected by COVID-19. Although kidney abnormalities resolve in the majority of pediatric COVID-19 infections, particular attention should be paid to serum creatinine and electrolyte levels in patients affected by COVID-19, particularly children with a history of malnutrition and kidney disorders.

Bartter syndrome is a rare genetic disease with 5 subtypes. In Bartter syndrome type 4, patients suffer from deafness and renal dysfunction since infancy. In this report, we introduced a 16-year-old girl with congenital deafness without any previous renal complaints referred to our center due to ankle pain.

Eculizumab is a humanized monoclonal antibody targeting the C5 (complement 5) member of complement proteins and inhibiting its cleavage to C5a and C5b. Eculizumab has been proven to be effective in a wide array of nephrologic, neurologic, and hematologic pediatric disorders. Kidney disorders, particularly those with immune-mediated pathomechanism, are the most common indications of eculizumab, including atypical hemolytic uremic syndrome (aHUS), hemolytic uremic syndrome (HUS), membranoproliferative glomerulonephritis (MPGN), immunoglobulin A (IgA) nephropathy, hematopoietic stem cell transplant-associated thrombotic microangiopathy, and less commonly post-infectious glomerulonephritis and diffuse proliferative lupus nephritis. In this review, we aimed to summarize the current evidence on approved and off-label applications of eculizumab and their specific considerations in pediatric kidney disorders.