E.V. BOYKO, O.V. BORISOVA

 Samara State Medical University, Samara

Contact details:

Boyko E.V. — postgraduate student at the Department of Pediatric Infections

Address: 89 Chapaevskaya St., 443099 Samara, Russian Federation, tel.: +7 (846) 374-10-04 (4696), e-mail: katerina11_95@mail.ru

Acute intestinal infections (AII) in children are often complicated by acute kidney injury (AKI), which later becomes a risk factor for chronic kidney disease (CKD) and requires lifelong specific therapy. The identification of clinical and laboratory markers that can predict the development of acute kidney injury is an urgent task in pediatrics.

The purpose — to determine the clinical and anamnestic features of AII in children and to evaluate the diagnostic significance of standard and specific markers (cystatin C, α1-microglobulin of urine) in AKI development.

Material and methods. The prospective study compared two groups of patients. The first group consisted of children with AII and renal AKI who were in the intensive care unit (ICU) (n = 14); group II: children with AII and functional AKI (prerenal) (n = 40). The control group consisted of patients with AII without signs of AKI (n = 80). The study used clinical and anamnestic, anthropometric, laboratory, and instrumental methods.

Results. In children with acute intestinal infections, AKI was more likely to develop against a background of severe dehydration. A persistent increase in creatinine and urea reflected a profound decrease in glomerular filtration rate (GFR), while an increase in cystatin C in both AKI groups indicated an early, often subclinical deterioration in filtration function. A significant increase in α1 microglobulin in urine indicated pronounced tubular damage and made it possible to differentiate between functional and structural AKI.

Conclusion. Acute kidney injury in children with acute intestinal infections is characterized by a clear clinical and laboratory profile. Changes in the main and specific markers allows not only timely recognition of AKI, but also to assume its nature. This can serve as a basis for choosing the volume of infusion therapy, the dynamics of follow-up, and subsequent nephrological monitoring.

Key words: acute kidney injury, acute intestinal infections, cystatin C, α1-microglobulin

REFERENCES

1. Diarrhoeal disease: fact sheet / World Health Organization. Geneva: WHO, 2024, available at: https://who.int (accessed on: 02.04.2026).
2. Borisova O.V., Boyko E.V. Acute kidney injury as a complication of intestinal infections in children (literature review). Prakticheskaya meditsina, 2022, vol. 20, no. 7, pp. 20–25 (in Russ.).
3. Chugunova O.L., Grebёnkina E.Yu., Usenko D.V. et al. The value of cystatin C and various methods for calculating glomerular filtration rate in assessing renal impairment in children with acute intestinal infections. Almanakh klinicheskoy meditsiny, 2021, vol. 49, no. 3, pp. 197–206 (in Russ.). DOI: 10.18786/2072-0505-2021-49-015
4. Ostroye povrezhdeniye pochek (OPP): klinicheskiye rekomendatsii / Assotsiatsiya nefrologov, Nauchnoye obshchestvo nefrologov Rossii, 2020 [Acute kidney injury (AKI): clinical guidelines / Association of Nephrologists, Scientific Society of Nephrologists of Russia.], available at: https://rusnephrology.org/wp-content/uploads/2020/12/AKI_final.pdf (accessed on: 02.04.2026).
5. Mazankova L.N., Luzan P.Yu. Early diagnosis and prognosis of acute kidney injury associated with viral diarrhea of ​​various etiologies in children (literature review). Detskiye infektsii, 2023, vol. 22, no. 3, pp. 55–61 (in Russ.). DOI: 10.22627/2072-8107-2023-22-3-55-61
6. Kellum J., Romagnani P., Ashuntantang G., Kellum J.A. et al. Acute kidney injury. Nat. Rev. Dis. Primers, 2021, vol. 7, art. 52. DOI: 10.1038/s41572-021-00284-z
7. Kirichek E.Yu., Vykhodtseva G.I., Kolesnikova O.I. et al. Early diagnosis of acute kidney injury in children with acute intestinal infections accompanied by the development of toxicosis with exsicosis. Mat′ i ditya v Kuzbasse, 2025, no. 3 (102) (in Russ.).
8. Korabel′nikov D.E., Osipova N.A., Petrova T.V. Cystatin C: diagnostic and prognostic value in acute kidney injury. Farmakoekonomika. Sovremennaya farmakoekonomika i farmakoepidemiologiya, 2024, vol. 17, no. 3, pp. 190–199 (in Russ.). DOI: 10.17749/2070-4909/farmakoekonomika.2024.238
9. Rivetti G., Gizzone P., Petrone D. et al. Acute kidney injury in children: a focus for the general pediatrician. Children, 2024, vol. 11, art. 1004. DOI: 10.3390/children11091004