2018
DOI: 10.5409/wjcp.v7.i3.83
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Clinical features of acute kidney injury in patients with Kawasaki disease

Abstract: 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 … Show more

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Cited by 19 publications
(20 citation statements)
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“…We also observed C3 and IgA deposits in the kidney glomeruli of LCWE-induced KD vasculitis mice. Several reports describe the development of acute kidney injury involving immune complex deposition of IgA and C3 and immune complex-mediated glomerulonephritis with KD (Watanabe, 2018). Autopsy findings revealed that 73% of KD patients had renal artery involvement (Asachi, 1989).…”
Section: Discussionmentioning
confidence: 99%
“…We also observed C3 and IgA deposits in the kidney glomeruli of LCWE-induced KD vasculitis mice. Several reports describe the development of acute kidney injury involving immune complex deposition of IgA and C3 and immune complex-mediated glomerulonephritis with KD (Watanabe, 2018). Autopsy findings revealed that 73% of KD patients had renal artery involvement (Asachi, 1989).…”
Section: Discussionmentioning
confidence: 99%
“…Kawasaki disease affects small and medium sized vessels, particularly the coronary arteries; however, dilatations and aneurysms can occur systemically, including in the axillary, subclavian, brachial, renal and iliac arteries as well as the abdominal aorta 23,[118][119][120] . Post-mortem findings have revealed that 73% of patients with Kawasaki disease have renal artery involvement and acute kidney injury 121 involving glomerulonephritis with intracapillary changes and deposition of immune complex composed of IgA and complement component 3 (C3) 22,122,123 . These findings are comparable to those in two other human vasculitis diseases, IgA vasculitis (IgAV) and IgA nephropathy (IgAN), which are similarly characterized by IgA immune complexes with C3 deposition in kidney glomeruli (see below).…”
Section: Myocarditis Most Attention In Kawasaki Diseasementioning
confidence: 99%
“…The precise pathogenesis is not completely understood, but several possible mechanisms have been proposed: immune-complex mediated kidney injuries, T-cell immune-regulatory abnormalities, renal and glomerular endothelial injury resulting from vasculitis and capillary leak, and an increased release of cytokines. 27,28 Kawasaki disease shock syndrome could be also suspected in this case, but the child had normal blood pressure values over the entire acute illness, and no signs of poor peripheral perfusion, so the requirements for concurrent KD shock syndrome proposed by Kanegaye et al in 2009 were not met. 29 The main objectives of KD are to control the systemic inflammatory response, to reduce the prevalence of coronary aneurysms and to prevent coronary thrombosis.…”
Section: Discussionmentioning
confidence: 82%
“…A diagnosis of acute gastroenteritis and dehydration was established. Laboratory tests showed: leukocytosis (29,300/µL), neutrophilia (27,200/µL), elevated erythrocyte sedimentation rate (ESR=76 mm/h) and elevated C-reactive protein (CRP=13.3 mg/dL), normochromic normocytic anemia (Hemoglobin = 10.7 g/dL), metabolic acidosis (pH = 7.33; HCO 3 = 14.3 mmol/L; BE = −13.3 mmol/L), hyponatremia (133 mmol/L), hypopotassemia (3.2 mmol/L) and hyperchloremia (119 mmol/L). Stool sample analysis did not identify any pathological aspects.…”
Section: Case Reportmentioning
confidence: 99%