Analysis of risk factors for acute kidney injury in children with severe wasp stings

Abstract

Abstract Background: Acute kidney injury (AKI) is common in children with sepsis, chronic kidney disease (CKD), poisoning or other conditions. Wasp sting is recognized as an important etiology of AKI. Several retrospective studies have investigated AKI after wasp stings were reported in adults, but researches in children remain limited. This study retrospectively analyzed the clinical characteristics of 48 children with severe wasp stings to identify the risk factors for acute kidney injury in this population. Methods: This study included 48 children with multiple organ dysfunction syndrome (MODS) after wasp stings injuries. Demographic data, clinical manifestations, laboratory findings, management and clinical outcomes were collected, statistically analyzed and compared to identify early indicators or risk factors for acute kidney injury. The cases were divided into AKI and non-AKI group. Results: Out of 48 children, 20 (41.7%) developed AKI, 28 (58.3%) did not. Among the children with AKI (16/20, 80%), it is observed that serum creatine level elevated within 24h since the wasp stings. Comparing the AKI and non-AKI groups, the AKI group exhibited more cases of cola-colored urine, oliguria and jaundice, higher sting number/body surface area (BSA) and sequential organ failure assessment scores (SOFA), as well as a higher level of C-reactive protein, alanine aminotransferase, aspartate aminotransferase, total bilirubin, lactate dehydrogenase, troponin, creatine kinase and prothrombin time. Multivariable logistic regression analysis identified cola-colored urine as a potential early risk factor for AKI. Conclusions: This retrospective study explored the risk factors for AKI in children after severe wasp stings. The AKI group presented higher levels in the sting number/BSA, CRP, ALT, AST, TBIL, LDH, cTnI, and CK. It is also found that cola-colored urine may serve as an early indicator or potential risk factor for AKI after wasp stings in children, which is very easy to identify for first aiders or pediatricians.