Acute kidney injury associated with urinary stone disease in children and young adults presenting to a pediatric emergency department.

Title

Acute kidney injury associated with urinary stone disease in children and young adults presenting to a pediatric emergency department.

Creator

Farris N; Raina R; Tibrewal A; Brown M; Colvis M; Schwaderer A; Kusumi K

Publisher

Frontiers in Pediatrics

Date

2020
1905-07

Description

Background: Acute kidney injury (AKI) due to urinary stone disease (USD) is rare in adults; AKI rates in children with USD may be higher, and emerging data links stones to chronic kidney disease (CKD) development in adults. Methods: This study is a retrospective analysis of USD patients at a single pediatric hospital system's emergency department (ED). Patients were initially identified by USD ICD codes; USD was then confirmed by imaging or physician documentation; patients had to have baseline creatinine (Cr) and Cr in the ED for comparison to be included. AKI was defined by Kidney Disease: Improving Global Outcomes (KDIGO), Acute Kidney Injury Network (AKIN), and Pediatric Risk, Injury, Failure, Loss, End Stage (pRIFLE). Results: Of the 589 total visits, 264/589 (45%) had data to evaluate for AKI, 23% were AKI(+) and 77% were AKI(-). pRIFLE was most common (82%) and 18% were only positive by AKIN/KDIGO. AKI(+) were more likely to be younger (16.7 vs. 17.4 years, p = 0.046) and more likely to present with vomiting {odds ratio [OR] [95% confidence interval (CI)]: 2.4 [1.4-4.3], p = 0.002}; also, the proportion of AKI(+) was significantly higher in <18 vs. ≥18 years [26.9 vs. 15.5%, p = 0.032, OR (95% CI): 2.0 (1.1-3.9)]. Urinary tract infection (UTI) and obstruction rates were similar between groups. AKI(+) patients had a significant OR <1 suggesting less risk of receiving non-steroidal anti-inflammatory drugs (NSAIDs); however, 51% of them did receive NSAIDs during their ED encounter. AKI(+) patients were more likely to require admission to the hospital (53 vs. 32%, p = 0.001). Conclusion: We have demonstrated a novel association between USD-induced renal colic and AKI in a group of young adults and children. AKI(+) patients were younger and were more likely to present with vomiting. AKI(+) patients did not have higher rates of obstruction or UTI, and 51% of AKI(+) received NSAIDs.

Subject

AKI; kidney stones; pediatric; urinary stone disease (USD); urolithiasis

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Format

journalArticle

Search for Full-text

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Pages

591520

Volume

8

ISSN

2296-2360

NEOMED College

NEOMED College of Medicine

NEOMED Department

Department of Pediatrics
Department of Internal Medicine

Update Year & Number

January 2021 List

Affiliated Hospital

Akron Children's Hospital

Citation

Farris N; Raina R; Tibrewal A; Brown M; Colvis M; Schwaderer A; Kusumi K, “Acute kidney injury associated with urinary stone disease in children and young adults presenting to a pediatric emergency department.,” NEOMED Bibliography Database, accessed June 21, 2021, https://neomed.omeka.net/items/show/11514.

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