Renal manifestations of Kawasaki's disease

Nardi, Piero; Haller, Jack O.; Friedman, A. P.; Slovis, T. L.; Schaffer, R M

doi:10.1007/bf02388716

Cited by 38 publications

(25 citation statements)

References 13 publications

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“…Acute renal failure has been a rare, but severe renal manifestation associated with KD (14 -16). Enlarged kidneys were always reported as a finding of acute renal failure in patients with KD (14,15). In this study, most of our patients had enlarged kidneys, whereas no patients had evidence of acute renal failure (normal serum creatinine for all patients).…”

Section: Discussionsupporting

confidence: 45%

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Nephromegaly in Children with Kawasaki Disease: New Supporting Evidence for Diagnosis and Its Possible Mechanism

et al. 2008

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ABSTRACT:To measure the kidney size in children with Kawasaki disease (KD) and to delineate the condition of nephromegaly, 20 children with KD were enrolled in our study. Kidney sizes were measured during acute stage in these patients. Twenty healthy children and 15 febrile children served as healthy controls and fever controls, respectively. To delineate the possible mechanism, we also evaluated kidney volume (KV) in 13 other patients with KD during the acute phase and after the recovery phase as well as 26 healthy children. Plasma hepatocyte growth factor (HGF) and transforming growth factor-␤1 (TGF-␤1) levels were determined for all children. Kidney lengths and KV in patients with KD during the acute phase were significantly larger than those of healthy children. There was no kidney enlargement in healthy controls and after the recovery phase. The ratio of patient plasma HGF/TGF-␤1 during the acute phase and after the recovery phase correlated positively with the degree of nephromegaly in all patients. These results confirm the presence of large kidneys in children with KD. Our data also suggest that an elevated HGF/TGF-␤1 ratio may be responsible for the transient nephromegaly in these children.

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Section: Discussionsupporting

confidence: 45%

“…Nardi et al (14) speculated that enlarged kidneys in KD might be explained by a vasculitis involving the kidneys with resultant fibrinoid deposits and cellular infiltrations subsequently leading to ischemia followed by edema. However, this proposed mechanism seems unable to explain enlarged kidneys in our patients without renal impairment.…”

Section: Discussionmentioning

confidence: 99%

Nephromegaly in Children with Kawasaki Disease: New Supporting Evidence for Diagnosis and Its Possible Mechanism

et al. 2008

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“…Nephrotic syndrome may develop during the course of the disease with a spontaneous remission without steroid therapy [17]. Nardi et al described an enhanced corticomedullary differentiation and cortical hyperechogenicity in four of seven children with KD [11]. The authors hypothesized a renal vasculitis due to fibrinoid deposits and cellular infiltration-induced ischemia.…”

Section: Kawasaki Disease (Kd)mentioning

confidence: 97%

“…Renal involvement is not common. Sterile pyuria and proteinuria are the most frequent features [10][11][12]. Acute renal failure with tubulointerstitial changes has been reported in a few patients [13][14][15][16].…”

Section: Kawasaki Disease (Kd)mentioning

confidence: 99%

Renal Involvement in Children with Vasculitis

Özen¹,

Orhan²

2014

Pediatric Nephrology

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“…The most common presentations are sterile pyuria and proteinuria; fewer patients have transient microscopic hematuria [2,3,8,9]. Although they are rare, severe complications such as renovascular hypertension, hemolytic uremic syndrome, interstitial nephritis, and acute renal failure have been reported [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Renal scarring sequelae in childhood Kawasaki disease

et al. 2007

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To assess renal inflammation and its sequelae in Kawasaki disease (KD) patients, we conducted a prospective study in a university medical center setting in Taiwan. From June 2002 to January 2005, 50 children with KD were enrolled, and after admission, all received technetium-99m dimercaptosuccinic acid scintigraphy single photon emission computed tomography (DMSA renal SPECT), the results of which were used as the reference standard for determining renal inflammation. Patients with renal inflammation underwent another DMSA renal SPECT more than 6 months later to evaluate the sequelae. We found that 26 of the 50 patients (52%) had renal inflammatory foci. There were no significant relationships between clinical or laboratory parameters and renal involvement in KD, except the presence of coronary artery lesions [P<0.01; odds ratio (OR) 5.18; 95% confidence interval (CI) 1.52-17.65]. Although all patients were free of clinical symptoms, the 6-month follow-up DMSA renal SPECT showed renal scarring in 11 of the 24 patients (46%). Patients with an initial abnormal renal ultrasound did predict a greatly increased risk of scarring (P<0.05; OR 16.2; 95% CI 1.27-206.20). In conclusion, this study demonstrated that the potential long-term clinical impact of KD is not limited to coronary artery lesion sequelae but also includes renal scar formation.

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Renal manifestations of Kawasaki's disease

Cited by 38 publications

References 13 publications

Nephromegaly in Children with Kawasaki Disease: New Supporting Evidence for Diagnosis and Its Possible Mechanism

Nephromegaly in Children with Kawasaki Disease: New Supporting Evidence for Diagnosis and Its Possible Mechanism

Renal Involvement in Children with Vasculitis

Renal scarring sequelae in childhood Kawasaki disease

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