COVID-19 Information

Public health information (CDC) | Research information (NIH) | SARS-CoV-2 data (NCBI) | Prevention and
treatment information (HHS) | Español

Log in

Search
Advanced

Save Email Send to Display options

Ren Fail. 2017 Nov;39(1):323-327. doi: 10.1080/0886022X.2016.1277743.

Acute kidney injury in idiopathic nephrotic syndrome

of childhood is a major risk factor for the
development of chronic kidney disease
Afshan Yaseen 1 , Vina Tresa 1 , Ali Asghar Lanewala 1 , Seema Hashmi 1 , Irshad Ali 1 ,
Sabeeta Khatri 1 , Muhammed Mubarak 1

Affiliations expand
PMID: 28093933 PMCID: PMC6014292 DOI: 10.1080/0886022X.2016.1277743
Free PMC article

Full text links Cite

Abstract
Background: Acute kidney injury (AKI) is an important complication of idiopathic nephrotic
syndrome (INS) and is associated with adverse outcomes, especially the development of chronic
kidney disease (CKD). We aimed to determine the clinical profile of children with INS who
developed AKI and its short-term outcome.

Material and methods: This prospective study was conducted from March 2014 to October 2015.
A total of 119 children of INS (age: 2-18 years) fulfilling the pediatric RIFLE criteria for the diagnosis
of AKI were enrolled and followed up for 3 months to determine the outcome. Factors predisposing
to CKD were studied.

Results: The mean age at presentation was 8.8 ± 3.59 years and males were 74 (62.2%). At
presentation, 61 (51.3%) children were in Risk category, 43 (36.1%) in Injury category, and 15
(12.6%) in Failure category. Most of them (41.2%) had steroid-resistant nephrotic syndrome (SRNS)
and focal segmental glomerulosclerosis (FSGS) on histopathology (33.6%). Infections were the
major predisposing factor for AKI in 67 (56.3%) cases. Drug toxicity was the next common, found in
52 (43.7%) children. A total of 65 (54.6%) children recovered from AKI, while 54 (45.4%) did not.
CKD developed in 49 (41.2%) non-recovered cases and 5 (4.2%) children succumbed to acute
illness. SRNS, cyclosporine use, FSGS on histology, and drug toxicity were significant factors
associated with the development of CKD.

Conclusion: AKI associated with INS is a reversible condition in most cases but it can progress to
CKD, especially among those who have SRNS, FSGS, and drug toxicity.

Keywords: Acute kidney injury; Pakistan; children; chronic kidney disease; idiopathic nephrotic
syndrome.

Figures

Figure 1. Most likely

etiological factors
leading…

Similar articles
Prospective 5-year follow-up of cyclosporine treatment in children with steroid-resistant
nephrosis.
Hamasaki Y, Yoshikawa N, Nakazato H, Sasaki S, Iijima K, Nakanishi K, Matsuyama T, Ishikura K, Ito S, Kaneko T,
Honda M; for Japanese Study Group of Renal Disease in Children.
Pediatr Nephrol. 2013 May;28(5):765-71. doi: 10.1007/s00467-012-2393-4. Epub 2013 Jan 13.
PMID: 23314441 Clinical Trial.

Idiopathic nephrotic syndrome in South African children.

Bakhiet YM, Mudi A, Khumalo T, Moonsamy G, Levy C.
Afr Health Sci. 2017 Dec;17(4):1130-1136. doi: 10.4314/ahs.v17i4.22.
PMID: 29937885 Free PMC article.

Childhood idiopathic steroid-resistant nephrotic syndrome at a Single Center in

Khartoum.
Ali EMA, Makki HFK, Abdelraheem MB, Makke SO, Allidir RA.
Saudi J Kidney Dis Transpl. 2017 Jul-Aug;28(4):851-859.
PMID: 28748888

Steroid-resistant idiopathic childhood nephrosis: overdiagnosed and undertreated.

Ehrich JH, Geerlings C, Zivicnjak M, Franke D, Geerlings H, Gellermann J.
Nephrol Dial Transplant. 2007 Aug;22(8):2183-93. doi: 10.1093/ndt/gfm092. Epub 2007 May 15.
PMID: 17504846

Acute kidney injury in children and its potential consequences in adulthood.

Goldstein SL.
Blood Purif. 2012;33(1-3):131-7. doi: 10.1159/000334143. Epub 2012 Jan 20.
PMID: 22269297 Review.

See all similar articles

Cited by 11 articles

Factors predicting the recovery from acute kidney injury in children with primary
nephrotic syndrome.
Guan N, Yao Y, Xiao H, Ding J, Zhong X, Wang F, Liu X, Zhang H, Su B.
Clin Exp Nephrol. 2021 Sep;25(9):1011-1017. doi: 10.1007/s10157-021-02074-z. Epub 2021 May 15.
PMID: 33991281

Lower albumin level and longer disease duration are risk factors of acute kidney injury in
hospitalized children with nephrotic syndrome.
Yang EM, Yoo KH, Ahn YH, Kim SH, Lee JW, Chung WY, Cho MH, Kim KH, Cho H, Lee MJ, Suh JS, Hyun HS, Lee
JM, Cho MH, Kim JH, Ha IS, Cheong HI, Kang HG.
Pediatr Nephrol. 2021 Mar;36(3):701-709. doi: 10.1007/s00467-020-04740-y. Epub 2020 Sep 5.
PMID: 32888043

Nephrotic syndrome-associated hypercoagulopathy is alleviated by both pioglitazone

and glucocorticoid which target two different nuclear receptors.
Waller AP, Agrawal S, Wolfgang KJ, Kino J, Chanley MA, Smoyer WE, Kerlin BA; Pediatric Nephrology Research
Consortium (PNRC).
Physiol Rep. 2020 Aug;8(15):e14515. doi: 10.14814/phy2.14515.
PMID: 32776495 Free PMC article.

Infections and risk of end-stage renal disease in patients with nephrotic syndrome: a
nationwide population-based case-control study.
Lin CH, Hung PH, Liu WS, Hu HY, Chung CJ, Chen TH.
Ann Transl Med. 2020 Mar;8(5):228. doi: 10.21037/atm.2020.01.02.
PMID: 32309375 Free PMC article.

Timing and predictive factors of developing chronic kidney disease in childhood-onset

idiopathic nephrotic syndrome: an Asian experience.
Mohd Idris SS, Nasir A, Nik Ismail NZA, Rostenberghe HAV, Ilias MI.
Singapore Med J. 2020 Sep;61(9):483-486. doi: 10.11622/smedj.2019096. Epub 2019 Sep 6.
PMID: 31489435 Free PMC article.

See all "Cited by" articles

References
1. Rheault MN, Wei CC, Hains DS, Wang W, Kerlin BA, Smoyer WE.. Increasing frequency of
acute kidney injury amongst children hospitalized with nephrotic syndrome. Pediatr Nephrol.
2014;29:139–147. - PMC - PubMed
2. Gipson DS, Messer KL, Tran CL, et al. . Inpatient health care utilization in the United States
among children, adolescents, and young adults with nephrotic syndrome. Am J Kidney Dis.
2013;61:910–917. - PubMed
3. Rheault MN, Zhang L, Selewski DT, et al. . AKI in children hospitalized with nephrotic
syndrome. Clin J Am Soc Nephrol. 2015;10:2110–2118. - PMC - PubMed
4. Mason PD, Special acute renal problems In: Davidson AM, Cameron JS, Grunfeld JP, Kerr
DNS, Ritz E, Winearls CG, eds. Oxford Textbook of Clinical Nephrology, 2nd ed.New York:
Oxford Medical Publications; 1998: 1631–1632.
5. Smith JD, Hayslett JP.. Reversible renal failure in the nephrotic syndrome. Am J Kidney Dis.
1992;19:201–213. - PubMed

Show all 21 references

MeSH terms
Acute Kidney Injury* / complications
Acute Kidney Injury* / diagnosis
Acute Kidney Injury* / epidemiology
Adolescent
Child
Child, Preschool
Cyclosporine / pharmacology*
Disease Progression
Follow-Up Studies
Glomerulosclerosis, Focal Segmental / pathology*
Glucocorticoids / pharmacology*
Humans
Immunosuppressive Agents / pharmacology
Kidney / pathology
Kidney Function Tests / methods
Male
Nephrotic Syndrome* / complications
Nephrotic Syndrome* / epidemiology
Pakistan / epidemiology
Prognosis
Renal Insufficiency, Chronic* / diagnosis
Renal Insufficiency, Chronic* / etiology
Renal Insufficiency, Chronic* / physiopathology
Renal Insufficiency, Chronic* / prevention & control
Risk Assessment / methods
Risk Factors

Substances
Glucocorticoids
Immunosuppressive Agents
Cyclosporine

Supplementary concepts
Nephrosis, congenital

Related information
MedGen
PubChem Compound (MeSH Keyword)

LinkOut - more resources

Full Text Sources
Europe PubMed Central
PubMed Central
Taylor & Francis

Other Literature Sources

scite Smart Citations

Medical
Genetic Alliance
MedlinePlus Health Information

NCBI Literature Resources MeSH PMC Bookshelf Disclaimer

FOLLOW NCBI

Connect with NLM National Library of Web Policies Help

Medicine FOIA Accessibility
8600 Rockville Pike Careers
Bethesda, MD 20894

NLM NIH HHS USA.gov