PT  - JOURNAL ARTICLE
AU  - Stewart, Douglas John
AU  - Mudalige, Nadeesha Lakmal
AU  - Johnson, Mae
AU  - Shroff, Rukshana
AU  - du Pré, Pascale
AU  - Stojanovic, Jelena
TI  - Acute kidney injury in paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) is not associated with progression to chronic kidney disease
AID  - 10.1136/archdischild-2021-322866
DP  - 2022 Mar 01
TA  - Archives of Disease in Childhood
PG  - e21--e21
VI  - 107
IP  - 3
4099  - http://adc.bmj.com/content/107/3/e21.short
4100  - http://adc.bmj.com/content/107/3/e21.full
SO  - Arch Dis Child2022 Mar 01; 107
AB  - Background Paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) is a rare complication of SARS-CoV-2 associated with single or multiorgan dysfunction.Objective We aimed to evaluate the incidence of acute kidney injury (AKI) and risk factors for kidney dysfunction in PIMS-TS, with reporting of 6-month renal follow-up data. We also evaluated renal involvement between first and second waves of the SARS-CoV-2 pandemic in the UK, the latter attributed to the Alpha variant.Design A single-centre observational study was conducted through patient chart analysis.Setting Data were collected from patients admitted to Great Ormond Street Hospital, London, UK, between April 2020 and March 2021.Patients 110 patients <18 years of age.Main outcome measure AKI during hospitalisation. AKI classification was based on upper limit of reference interval (ULRI) serum creatinine (sCr) values.Results AKI occurred in 33 (30%) patients. Hypotension/hypoperfusion was associated with almost all cases. In univariate analysis, the AKI cohort had higher peak levels of triglycerides (OR, 1.27 (95% CI, 1.05 to 1.6) per 1 mmol/L increase) and C reactive protein (OR, 1.06 (95% CI, 1.02 to 1.12) per 10 mg/L increase), with higher requirement for mechanical ventilation (OR, 3.8 (95% CI, 1.46 to 10.4)) and inotropic support (OR, 15.4 (95% CI, 3.02 to 2.81)). In multivariate analysis, triglycerides were independently associated with AKI stages 2–3 (adjusted OR, 1.26 (95% CI, 1.04 to 1.6)). At follow-up, none had macroalbuminuria and all had sCr values <ULRI. No discrepancy in renal involvement between pandemic waves was found.Conclusion Despite a high incidence of AKI in PIMS-TS, renal recovery occurs rapidly with current therapies, and no patients developed chronic kidney disease.Data are available upon reasonable request. De-identified patient datasets are available from the corresponding author on written request.