Acute kidney injury in patients with Kawasaki disease

Abstract

Background: Kawasaki disease was well known for coronary artery abnormalities with few reports of incidence of acute kidney injury (AKI). Our aim was to identify the rate of AKI in patients with Kawasaki disease and its associated factors. Methods: All patients with Kawasaki disease admitted to a medical center from February 2004 to August 2014 were evaluated. Data collection included serum creatinine level, serial echocardiography reports, white blood cell count, C-reactive protein level, alanine transaminase level, urine white blood cell count, and renal ultrasound reports if available. AKI was defined when a patient's serum creatinine level was higher than 1.5 times upper limits of age-specific serum creatinine levels. Results: This cohort study included 332 patients (191 boys and 141 girls; aged 0.12 to 11.3 y, median 1.39 y) and 93 patients (28%) of them had AKI. Multivariate logistic regression revealed that age and alanine transaminase level were significantly associated with AKI (odds ratio (OR): 0.521, 95% confidence interval (CI): 0.377-0.718, P < 0.001, and OR: 1.003, 95% CI: 1.000-1.005, P = 0.017, respectively). Conclusion: This study demonstrated that AKI exists in substantial proportion of patients with KD. Young age and high alanine transaminase level are the main associated factors for AKI in these patients.