Valentino Maria Sole, Marzuillo Pierluigi, Esposito Claudia, Bartiromo Mario, Nardolillo Michele, Villani Annalisa Valentina, Maresca Alessandro, Furcolo Giuseppe, Guarino Stefano, Miraglia Del Giudice Emanuele, Di Sessa Anna
Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
Unità Operativa Complessa di Pediatria e Pronto Soccorso Pediatrico, AORN Moscati, 83100 Avellino, Italy.
J Clin Med. 2023 Mar 4;12(5):2037. doi: 10.3390/jcm12052037.
Both direct and indirect effects of COVID-19 have been found in all age groups. In particular, adult data demonstrated significant changes in patients with chronic and metabolic disease (e.g., obesity, diabetes, chronic kidney disease (CKD), and metabolic associated fatty liver dysfunction (MAFLD)), while similar pediatric evidence is still limited. We aimed at investigating the impact of the COVID-19 pandemic lockdown on the relationship between MAFLD and renal function in children with CKD due to congenital abnormalities of the kidney and urinary tract (CAKUT).
A total of 21 children with CAKUT and CKD ≥ stage 1 underwent a comprehensive evaluation within 3 months before and 6 months after the first Italian lockdown.
At follow-up, CKD patients with MAFLD presented higher BMI-SDS, serum uric acid, triglycerides, and microalbuminuria levels and lower eGFR levels than those without MAFLD (all < 0.05). Higher ferritin and white blood cell concentrations were also found in patients with CKD diagnosed with MAFLD than peers without MAFLD (both = 0.01). Compared to children without MAFLD, a higher delta of BMI-SDS, eGFR levels, and microalbuminuria levels was found in patients with MAFLD.
Due to the negative influence of the COVID-19 lockdown on cardiometabolic health in childhood, a careful management of children with CKD is warranted.
在所有年龄组中均发现了新冠病毒病（COVID-19）的直接和间接影响。特别是，成人数据显示，慢性和代谢性疾病（如肥胖、糖尿病、慢性肾脏病（CKD）和代谢相关脂肪性肝病（MAFLD））患者有显著变化，而类似的儿科证据仍然有限。我们旨在研究COVID-19大流行封锁对因先天性肾脏和尿路异常（CAKUT）导致CKD的儿童中MAFLD与肾功能之间关系的影响。
共有21例CAKUT且CKD≥1期的儿童在意大利首次封锁前3个月和封锁后6个月内接受了全面评估。
随访时，患有MAFLD的CKD患者比未患MAFLD的患者表现出更高的BMI-SDS、血清尿酸、甘油三酯和微量白蛋白尿水平，以及更低的估算肾小球滤过率（eGFR）水平（均P<0.05）。与未患MAFLD的同龄人相比，诊断为MAFLD的CKD患者还发现铁蛋白和白细胞浓度更高（均P = 0.01）。与未患MAFLD的儿童相比，患有MAFLD的患者BMI-SDS、eGFR水平和微量白蛋白尿水平的变化更大。
由于COVID-19封锁对儿童心脏代谢健康有负面影响，因此有必要对CKD儿童进行仔细管理。
