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  1. Article ; Online: Critical analysis of acute kidney injury in pediatric COVID-19 patients in the intensive care unit.

    Raina, Rupesh / Chakraborty, Ronith / Mawby, Isabelle / Agarwal, Nirav / Sethi, Sidharth / Forbes, Michael

    Pediatric nephrology (Berlin, Germany)

    2021  Volume 36, Issue 9, Page(s) 2627–2638

    Abstract: Background and objectives: COVID-19 is responsible for the 2019 novel coronavirus disease pandemic. Despite the vast research about the adult population, there has been little data collected on acute kidney injury (AKI) epidemiology, associated risk ... ...

    Abstract Background and objectives: COVID-19 is responsible for the 2019 novel coronavirus disease pandemic. Despite the vast research about the adult population, there has been little data collected on acute kidney injury (AKI) epidemiology, associated risk factors, treatments, and mortality in pediatric COVID-19 patients admitted to the ICU. AKI is a severe complication of COVID-19 among children and adolescents.
    Methods: A comprehensive literature search was conducted in PubMed/MEDLINE and Cochrane Center Trials to find all published literature related to AKI in COVID-19 patients, including incidence and outcomes.
    Results: Twenty-four studies reporting the outcomes of interest were included. Across all studies, the overall sample size of COVID positive children was 1,247 and the median age of this population was 9.1 years old. Among COVID positive pediatric patients, there was an AKI incidence of 30.51%, with only 0.56% of these patients receiving KRT. The mortality was 2.55% among all COVID positive pediatric patients. The incidence of multisystem inflammatory syndrome in children (MIS-C) among COVID positive patients was 74.29%.
    Conclusion: AKI has shown to be a negative prognostic factor in adult patients with COVID-19 and now also in the pediatric cohort with high incidence and mortality rates. Additionally, our findings show a strong comparison in epidemiology between adult and pediatric COVID-19 patients; however, they need to be confirmed with additional data and studies.
    MeSH term(s) Acute Kidney Injury/epidemiology ; Acute Kidney Injury/immunology ; Acute Kidney Injury/therapy ; Acute Kidney Injury/virology ; Adult ; Age Factors ; COVID-19/complications ; COVID-19/diagnosis ; COVID-19/immunology ; COVID-19/mortality ; Child ; Hospital Mortality ; Humans ; Incidence ; Intensive Care Units/statistics & numerical data ; Pandemics/statistics & numerical data ; Renal Replacement Therapy/statistics & numerical data ; Risk Factors ; SARS-CoV-2/isolation & purification ; SARS-CoV-2/pathogenicity ; Systemic Inflammatory Response Syndrome/complications ; Systemic Inflammatory Response Syndrome/diagnosis ; Systemic Inflammatory Response Syndrome/immunology ; Systemic Inflammatory Response Syndrome/mortality
    Language English
    Publishing date 2021-04-29
    Publishing country Germany
    Document type Journal Article ; Systematic Review
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-021-05084-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Re-evaluating Renal Angina Index: An Authentic, Evidence-Based Instrument for Acute Kidney Injury Assessment: Critical Appraisal.

    Raina, Rupesh / Sethi, Sidharth Kumar / Mawby, Isabelle / Datla, Nikhil / Kumar, Nikhita / Agarwal, Nirav / Tibrewal, Abhishek / Chakraborty, Ronith

    Frontiers in pediatrics

    2021  Volume 9, Page(s) 682672

    Abstract: Background/Introduction: ...

    Abstract Background/Introduction:
    Language English
    Publishing date 2021-07-29
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2021.682672
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Dialysis disequilibrium syndrome (DDS) in pediatric patients on dialysis: systematic review and clinical practice recommendations.

    Raina, Rupesh / Davenport, Andrew / Warady, Bradley / Vasistha, Prabhav / Sethi, Sidharth Kumar / Chakraborty, Ronith / Khooblall, Prajit / Agarwal, Nirav / Vij, Manan / Schaefer, Franz / Malhotra, Kunal / Misra, Madhukar

    Pediatric nephrology (Berlin, Germany)

    2021  Volume 37, Issue 2, Page(s) 263–274

    Abstract: Background and objectives: Dialysis disequilibrium syndrome (DDS) is a rare neurological complication, most commonly affecting patients undergoing new initiation of hemodialysis (HD), but can also be seen in patients receiving chronic dialysis who miss ... ...

    Abstract Background and objectives: Dialysis disequilibrium syndrome (DDS) is a rare neurological complication, most commonly affecting patients undergoing new initiation of hemodialysis (HD), but can also be seen in patients receiving chronic dialysis who miss regular treatments, patients having acute kidney injury (AKI), and in those treated with continuous kidney replacement therapy (CKRT) or peritoneal dialysis (PD). Although the pathogenesis is not well understood, DDS is likely a result of multiple physiological abnormalities. In this systematic review, we provide a synopsis of the data available on DDS that allow for a clear picture of its pathogenesis, preventive measures, and focus on effective management strategies.
    Methods: We conducted a literature search on PubMed/Medline and Embase from January 1960 to January 2021. Studies were included if the patient developed DDS irrespective of age and gender. A summary table was used to summarize the data from individual studies and included study type, population group, age group, sample size, patient characteristics, blood and dialysate flow rate, and overall outcome. A descriptive analysis calculating the frequency of population size, symptoms, and various treatments was performed using R software version 3.1.0.
    Results: A total of 49 studies (321 samples) were identified and analyzed. Out of the included 49 studies, a total of 48 studies reported the presence of DSS among patients (1 study reported based on number of dialysis and therefore was not considered for analysis). Among these 48 studies, 74.3% (226/304) patients were reported to have DSS. The most common symptoms were nausea (25.2%), headache (24.8%), vomiting (23.9%), muscle cramps (18.1%), affected level of consciousness (8.8%), confusion (4.4%), and seizure (4.9%) among the 226 DDS patients. Furthermore, 12 studies decided to switch from HD to alternative dialysis modalities including continuous venovenous hemofiltration/hemodiafiltration (CVVH/CVVHDF) or PD which reported no DDS symptoms.
    Conclusion: Early recognition and timely prevention are crucial for DDS patients. We have provided comprehensive clinical practice points for pediatric, adolescent, and young adult populations. However, it is essential to recognize that DDS was reported more frequently in the early dialysis era, as there was a lack of advanced dialysis technology and limited resources.
    MeSH term(s) Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Acute Kidney Injury/therapy ; Adolescent ; Child ; Female ; Hemodiafiltration ; Humans ; Male ; Nausea/etiology ; Peritoneal Dialysis/adverse effects ; Renal Dialysis/adverse effects ; Syndrome ; Vomiting/etiology
    Language English
    Publishing date 2021-10-05
    Publishing country Germany
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-021-05242-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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