Medical Professional Publications

Acute Kidney Injury a Major Complication of Nephrotic Syndrome in Children

Columbus, OH - November 2016

Acute kidney injury (AKI) commonly occurs in critically ill patients and is associated with substantial morbidity and mortality. A multicenter study co-authored by clinical researchers at Nationwide Children’s Hospital and the Midwest Pediatric Nephrology Consortium (MWPNC) provides novel insights on the incidence, epidemiology and hospital outcomes associated with AKI in a recent cohort of children hospitalized with nephrotic syndrome.

“Children with nephrotic syndrome are at increased risk of developing life-threatening complications, including infection and thrombosis,” says William E. Smoyer, MD, a member of the Section of Nephrology at Nationwide Children’s, director of the Center for Clinical and Translational Research in The Research Institute at Nationwide Children’s and senior author of the study. “While AKI is associated with adverse outcomes in hospitalized children, little is known about the epidemiology of AKI in children with nephrotic syndrome.”

The study team found that AKI occurred more commonly than had been previously recognized in children hospitalized with nephrotic syndrome, according to Dr. Smoyer. Development of AKI was associated with lengthier hospital stays and an increased need for intensive care unit admission.

“AKI should be regarded as a third major complication of nephrotic syndrome in children, in addition to infection and venous thromboembolism,” Dr. Smoyer says. “The collaborative multi-center clinical and translational research being conducted through the Midwest Pediatric Nephrology Consortium (MWPNC) enables our members to more powerfully address important clinical problems in pediatric nephrology that are simply not able to be adequately addressed by a single center.”

The MWPNC was co-founded in 2004 by Drs. Smoyer and John D. Mahan, MD, also in the Section of Nephrology at Nationwide Children’s. The goal of the MWPNC is to develop and execute multi-center clinical and translational studies related to pediatric kidney diseases, driving improvements in the care of children with all forms of kidney disease.

In recent months, the consortium has published studies regarding vitamin D deficiency in incident nephrotic syndrome; improved cardiovascular risk factors in pediatric renal transplant recipients on steroid avoidance immunosuppression; and intestinal microbiota in patients with end stage renal disease.

The MWPNC now comprises approximately half of all pediatric nephrology programs in North America, spanning 70 centers. The consortium has published 35 manuscripts, with MWPNC studies having been awarded 19 NIH and industry grants totaling more than $6.1 million in direct costs. Currently, the MWPNC has 33 multi-center studies actively enrolling patients, with five additional studies under development.

Rheault Mn, Zhang L, Selewski DT, Kallash M, Tran CL, Seamon M, Katsoufis C, Ashoor I, Hernandez J, Supe-Markovina K, D’Alessandri-Silva C, DeJesus-Gonzalez N, Vasylyeva TL, Formeck C, Woll C, Gbadegesin R, Geier P, Devarajan P, Carpenter SL, Kerlin BA, Smoyer WE, Midwest Pediatric Nephrology Consortium. AKI in children hospitalized with nephrotic syndrome. Clinical Journal of the American Society of Nephrology. 2015 Dec 5;10(12):2110-8.

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