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Marcellino A, Bloise S, Pirone C, Brandino G, Barberi A, Del Giudice E, Martucci V, Sanseviero M, Ventriglia F, Lubrano R. Increased Measured GFR and Proteinuria in Children with Previous Infection by SARS-CoV-2: Should We Be Concerned? Microorganisms 2025; 13:1008. [PMID: 40431181 PMCID: PMC12113866 DOI: 10.3390/microorganisms13051008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2025] [Revised: 04/12/2025] [Accepted: 04/19/2025] [Indexed: 05/29/2025] Open
Abstract
Over the past 3 years, several kidney complications in children with severe involvement by SARS-CoV-2 have been described. However, literature data are still lacking regarding possible kidney injury in children with paucisymptomatic SARS-CoV-2 infection. Thus, we retrospectively evaluated renal function in those patients. Children between 3 and 18 years, without any renal disease, with previous paucisymptomatic SARS-CoV-2 infection from May 2020 to March 2022, were recruited at our post-COVID-19 outpatient clinic. We retrospectively collected: Glomerular filtration rate, Fractional-excretion-of-sodium (FENa), tubular-reabsorption-of-phosphate (TRP), calcium-creatinine-urine ratio (CaU/CrU); proteinuria/m2/day and microhematuria by urine cytofluorometry. A total of 148 children were enrolled after a median period of 3 (IQR 6) months after infection. Twenty-six patients (17.6%) had reduced GFR, fifty (33.9%) had hyperfiltration, eleven (7.4%) had abnormal FENa and/or TRP, twenty-two (14.9%) had hypercalciuria, seventy-eight (52.7%) had pathological daily proteinuria. Microhematuria was found in sixteen (10.9%) subjects. Hyperfiltration was more prevalent among males (38.9% vs. 22.4%, p = 0.027); CaU/CrU [median 0.08 (IQR 0.09) vs. 0.13 (IQR 0.13) p = 0.003] was significantly higher in females. Our data suggest that SARS-CoV-2 could determine, in a significant proportion of children, kidney damage characterized by hyperfiltration, proteinuria, and hematuria, warranting strict follow-up in these patients.
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Affiliation(s)
- Alessia Marcellino
- Pediatrics and Neonatology Unit, Maternal-Child Department, Santa Maria Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy; (S.B.); (G.B.); (E.D.G.); (V.M.); (M.S.); (F.V.)
| | - Silvia Bloise
- Pediatrics and Neonatology Unit, Maternal-Child Department, Santa Maria Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy; (S.B.); (G.B.); (E.D.G.); (V.M.); (M.S.); (F.V.)
| | - Carmelo Pirone
- Dermatopathic Institute of the Immaculate (IDI-IRCCS), 00167 Rome, Italy;
| | - Giulia Brandino
- Pediatrics and Neonatology Unit, Maternal-Child Department, Santa Maria Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy; (S.B.); (G.B.); (E.D.G.); (V.M.); (M.S.); (F.V.)
| | - Antonio Barberi
- Radiology Unit, Santa Maria Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy;
| | - Emanuela Del Giudice
- Pediatrics and Neonatology Unit, Maternal-Child Department, Santa Maria Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy; (S.B.); (G.B.); (E.D.G.); (V.M.); (M.S.); (F.V.)
| | - Vanessa Martucci
- Pediatrics and Neonatology Unit, Maternal-Child Department, Santa Maria Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy; (S.B.); (G.B.); (E.D.G.); (V.M.); (M.S.); (F.V.)
| | - Mariateresa Sanseviero
- Pediatrics and Neonatology Unit, Maternal-Child Department, Santa Maria Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy; (S.B.); (G.B.); (E.D.G.); (V.M.); (M.S.); (F.V.)
| | - Flavia Ventriglia
- Pediatrics and Neonatology Unit, Maternal-Child Department, Santa Maria Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy; (S.B.); (G.B.); (E.D.G.); (V.M.); (M.S.); (F.V.)
| | - Riccardo Lubrano
- Pediatrics and Neonatology Unit, Maternal-Child Department, Santa Maria Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy; (S.B.); (G.B.); (E.D.G.); (V.M.); (M.S.); (F.V.)
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Chang LY, Lin YH, Lin SJ, Chiang TL. Cohort Profile: Taiwan Birth Cohort Study (TBCS). Int J Epidemiol 2021; 50:1430-1431i. [PMID: 34263321 DOI: 10.1093/ije/dyab048] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 12/17/2022] Open
Affiliation(s)
- Ling-Yin Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Hsuan Lin
- Surveillance, Research and Health Education Division, Health Promotion Administration, Ministry of Health and Welfare, Taiwan
| | - Shio-Jean Lin
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
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Chen MC, Wang JH, Chen JS, Chang YC, Jan RH, Yang SH, Chu SY, Lai PC, Chu CH, Cheng CF, Chang YH. Socio-Demographic Factors Affect the Prevalence of Hematuria and Proteinuria Among School Children in Hualien, Taiwan: A Longitudinal Localization-Based Cohort Study. Front Pediatr 2020; 8:600907. [PMID: 33363066 PMCID: PMC7758220 DOI: 10.3389/fped.2020.600907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/11/2020] [Indexed: 11/29/2022] Open
Abstract
Objective: Child hematuria/proteinuria is a risk factor for chronic kidney disease (CKD) in later life, and mass urinary screening could detect asymptomatic glomerulonephritis at an early stage. This study aimed to evaluate the longitudinal prevalence of hematuria/proteinuria and its association with socio-demographic factors among school children in Hualien, Taiwan. Methods: The study cohort consisted of first and fourth graders enrolled from 2008 to 2015 in Hualien. We combined the data from two consecutive health examinations to ensure the validity of the body mass index (BMI), urbanization, proteinuria, and hematuria grouping. Prevalence and health status differences between sex, age, BMI, and urbanization level were examined. Results: A total of 16,990 students within the same BMI and urbanization categories were included during the study interval. The prevalence of persistent hematuria was 1.0%. Fourth graders (odds ratio OR: 1.68, p = 0.002), girls (OR: 1.48, p = 0.014), and students from suburban/rural areas (OR: 1.99, and OR: 4.93, respectively; both p < 0.001) demonstrated higher hematuria risk. The prevalence of proteinuria was 0.2%. Fourth graders (OR: 4.44, p < 0.001) and students in suburban areas (OR: 0.27, p = 0.031) were associated with persistent proteinuria. After stratifying by age, the significant association remained. A higher risk of proteinuria was noted in underweight subjects (OR: 2.52, p = 0.023) among the fourth-grade students. Conclusion: The prevalence of hematuria/proteinuria in Hualien was higher than the average reported for Taiwan. Hematuria/proteinuria was significantly associated with sex, age, BMI, and urbanization. Our longitudinal results can provide information for future pediatric CKD prevention in Taiwan.
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Affiliation(s)
- Ming-Chun Chen
- Department of Pediatric, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Jen-Hung Wang
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Jui-Shia Chen
- Department of Pediatric, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yung-Chieh Chang
- Department of Pediatric, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Rong-Hwa Jan
- Department of Pediatric, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Shang-Hsien Yang
- Department of Pediatric, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Shao-Yin Chu
- Department of Pediatric, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Pei-Chun Lai
- Department of Pediatric, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan.,Evidence-Based Medicine Center, Department of Medical Education, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chia-Hsiang Chu
- Department of Pediatric, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Ching-Feng Cheng
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Pediatric, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan
| | - Yu-Hsun Chang
- Department of Pediatric, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Pediatric, National Taiwan University Hospital, Hsinchu, Taiwan
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Kim S, Uhm JY. Individual and Environmental Factors Associated with Proteinuria in Korean Children: A Multilevel Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183317. [PMID: 31505832 PMCID: PMC6766052 DOI: 10.3390/ijerph16183317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 07/27/2019] [Accepted: 07/31/2019] [Indexed: 02/06/2023]
Abstract
Proteinuria is a significant sign of childhood renal disorders. However, little is known about how sociodemographic and environmental factors are related to the presence of proteinuria among children and adolescents. This paper focuses on the prevalence of proteinuria and its risk factors among children and adolescents. This study conducted a secondary analysis of data from the 2016 Sample Schools Raw Data of Health Examination for School Students (SSRDHESS). Data collected from 27,081 students who had undergone a health screening were analyzed using Chi-square tests, independent t-tests, and multilevel logistic regression analysis. The prevalence of proteinuria was higher in the thin group than in the normal weight group (adjusted odds ratio (aOR) = 1.77; 95% confidence interval (CI) = 1.34–2.33) and lower in the overweight/obese group (aOR = 0.64; 95% CI = 0.51–0.80). Additionally, those in metropolitan and small–medium sized cities had a proteinuria prevalence about 1.5-fold higher than that of those in rural areas (95% CI = 1.08–2.02, 95% CI = 1.19–1.92, respectively). Proteinuria was associated with environmental pollution, including smoking rate, ambient particulate matter and heavy metals in drinking water (aOR = 1.10; 95% CI = 1.01–1.20; aOR = 1.06; 95% CI = 1.01–1.11, aOR = 1.001; 95% CI = 1.0001–1.0015). These results suggest that to improve health management effectiveness, kidney disease prevention efforts for children and adolescents should focus on geographical area and environmental pollution, as well as body weight as individual factors.
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Affiliation(s)
- Suhee Kim
- School of Nursing and Research Institute of Nursing Science, Hallym University, Chuncheon-si, Gangwon-do 24252, Korea.
| | - Ju-Yeon Uhm
- Department of Nursing, Pukyong National University, Busan 48513, Korea.
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