Acute Kidney Injury and Cholestasis Associated With Kawasaki Disease in a 9-year-old: Case Report

Vázquez, José Allan Martínez; García, Carlos Sánchez; Muñoz, Lorena Rodríguez; Ramírez, Rogelio Osvaldo Martínez

doi:10.1016/j.reumae.2017.11.003

Cited by 4 publications

(4 citation statements)

References 10 publications

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“…Thirty-nine patients with KD who developed AKI have been reported in 28 publications as case reports[ 16 - 43 ]. The median age was 4.8 years (range, 3 mo-to-45 years).…”

Section: Epidemiologymentioning

confidence: 99%

“…In patients with KD, prerenal AKI associated with acute heart failure (AHF)[ 16 , 17 ] and intrinsic AKI have been reported. The causes of intrinsic AKI in KD include TIN[ 18 - 21 ], ANS[ 22 - 24 ], HUS[ 25 - 27 ], immune complex-mediated nephropathy[ 28 ], rhabdomyolysis[ 29 ], and KDSS[ 30 - 34 ] (Table 1 ); however, because only 8 of the reported KD patients with AKI underwent renal biopsies, the etiology of AKI was unknown in 25% of the patients[ 35 - 43 ].…”

Section: Causes Of Akimentioning

confidence: 99%

“…All of the patients were treated with IVIG and recovered without any sequelae. Martínez Vázquez et al[ 43 ] reported a 9-year-old girl with KD who developed oliguric AKI and cholestasis. The patient was treated with IVIG and intravenous pulses of methylprednisolone, which led to an improvement in the AKI and clinical features of KD, but she had CAAs.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

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Clinical features of acute kidney injury in patients with Kawasaki disease

Watanabe¹

2018

WJCP

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Although acute kidney injury (AKI) is a common complication in hospitalized children, AKI has rarely been reported in patients with Kawasaki disease (KD). Herein, we review the clinical trajectories of AKI in patients with KD. A total of 39 patients with KD who developed AKI have been reported in 28 publications as case reports. The causes of AKI include prerenal AKI associated with acute heart failure (AHF), intrinsic AKI caused by tubulointerstitial nephritis (TIN), acute nephritic syndrome (ANS), hemolytic uremic syndrome (HUS), immune complex-mediated nephropathy, rhabdomyolysis, and KD shock syndrome (KDSS). Six of the 39 patients (15.4%) underwent renal replacement therapy. While AHF and multiple organ dysfunction syndrome developed in 41% and 68% of KD patients with AKI, respectively, all patients recovered without any renal sequelae. Although the precise pathogenic mechanism underlying the development of AKI in patients with KD is unknown, several possible mechanisms have been proposed, including T-cell-mediated immunologic abnormalities for TIN, renal and glomerular endothelial injury resulting from vasculitis for HUS, immune complex-mediated kidney injury for immune complex-mediated nephropathy and ASN, and capillary leak and an increased release of cytokines with myocardial dysfunction for KDSS.

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“…Thirty-nine patients with KD who developed AKI have been reported in 28 publications as case reports[ 16 - 43 ]. The median age was 4.8 years (range, 3 mo-to-45 years).…”

Section: Epidemiologymentioning

confidence: 99%

Section: Causes Of Akimentioning

confidence: 99%

Section: Clinical Manifestationsmentioning

confidence: 99%

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Clinical features of acute kidney injury in patients with Kawasaki disease

Watanabe¹

2018

WJCP

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“…Cholestasis could develop in response to xenobiotics (e.g., alcohol or drugs) or diseases (3). It has been found that kidneys are the most affected extrahepatic organs during cholestasis (4). The accumulation of potentially cytotoxic chemicals (e.g., hydrophobic bile acids), which are routinely excreted through the bile flow, seems to play a fundamental role in developing cholestasis-induced renal injury or cholemic nephropathy (CN) (5).…”

Section: Introductionmentioning

confidence: 99%

Investigating the Protective Effect of Ellagic Acid on Cholemic Nephropathy in Cholestatic Rats

Kargar,

Mohammadi,

Amirizadeh

et al. 2024

Arch Neurosci

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Background: Cholemic nephropathy (CN), a renal dysfunction caused by bile acids, is a severe complication of chronic liver damage and bile duct ligation (BDL), which may lead to complete kidney failure. Objectives: This study investigated the protective effect of ellagic acid on CN in cholestatic rats. Methods: Sixty male Wistar rats weighing about 180 - 200 g were randomly divided into 6 groups for in vivo investigation. The rats were randomly divided into 5 groups of 10. Cholestasis was induced in rats by closing the bile ducts; then, the animals were treated with different doses of ellagic acid (10, 25, and 50 mg/kg). Then, the induction effect of cholestasis and the protective effects of ellagic acid on serum and urinary factors, oxidative stress indices, and histopathological changes in liver and kidney tissue were investigated. Results: Bile duct ligation in rats led to an increase in serum and urinary factors. It was also associated with increased reactive oxygen species (ROS), lipid peroxidation, glutathione (GSH) oxide form, decrease in antioxidant systems, GSH and severe histopathological changes, and fibrosis of the liver and kidney tissues. Another finding of this research was the beneficial effect of ellagic acid in improving serum and urinary factors, oxidative stress indices, and histopathological changes. Conclusions: Due to its antioxidant properties, ellagic acid can potentially serve as a novel therapeutic approach for treating kidney damage caused by increased serum levels of bile acids.

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