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Background <p>We aimed to investigate the prevalence and risk factors of acute kidney injury (AKI) at juvenile idiopathic arthritis (JIA) onset and its impact on long-term kidney outcomes.</p> Methods <p>In this multicenter study, we retrospectively reviewed 192 children diagnosed with JIA (1998–2025). AKI was defined according to KDIGO serum creatinine criteria. Kidney damage (KD) was defined as chronic kidney disease (CKD) and/or hypertension at follow-up. Logistic and Cox regression analyses were used to identify risk factors and to calculate odds ratio (OR) and hazard ratio (HR), respectively. Kaplan–Meier analysis evaluated KD-free survival.</p> Results <p>At JIA onset, 45 patients (23.4%) developed AKI, mostly stage 1, with no cases requiring dialysis. Independent predictors of AKI were younger age, elevated C-reactive protein, and ANA positivity. After a mean follow-up of 6.3 years (range 1–27.5), 23 patients (12%) developed KD (19 CKD, 4 hypertension, 2 both). Patients with AKI at onset had a significantly higher risk of KD (OR 5.8, 95% CI: 2.4–15.2; HR 3.7, 95% CI: 1.9–8.9). At 25.1 years of age, the cumulative proportion free from KD was 26.9% in patients with AKI versus 64.1% in those without (<i>p</i> = 0.005).</p> Conclusions <p>AKI is relatively frequent at JIA onset and represents a strong predictor of long-term kidney damage. Early recognition and careful follow-up of children with AKI may help identify those at greatest risk for adverse kidney outcomes.</p> Graphical abstract <p></p>

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Prevalence and risk factors for acute kidney injury at the diagnosis of juvenile idiopathic arthritis in children and its long-term implications for kidney health

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月3日

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  • Maria Francesca Gicchino,
  • Mattia Arenella,
  • Caterina De Simone,
  • Federica Di Domenico,
  • Maria Grazia Fusco,
  • Silvio Naviglio,
  • Paola Tirelli,
  • Giulio Rivetti,
  • Anna Di Sessa,
  • Stefano Guarino,
  • Emanuele Miraglia del Giudice,
  • Alma Nunzia Olivieri,
  • Francesca Orlando,
  • Pierluigi Marzuillo

摘要

Background

We aimed to investigate the prevalence and risk factors of acute kidney injury (AKI) at juvenile idiopathic arthritis (JIA) onset and its impact on long-term kidney outcomes.

Methods

In this multicenter study, we retrospectively reviewed 192 children diagnosed with JIA (1998–2025). AKI was defined according to KDIGO serum creatinine criteria. Kidney damage (KD) was defined as chronic kidney disease (CKD) and/or hypertension at follow-up. Logistic and Cox regression analyses were used to identify risk factors and to calculate odds ratio (OR) and hazard ratio (HR), respectively. Kaplan–Meier analysis evaluated KD-free survival.

Results

At JIA onset, 45 patients (23.4%) developed AKI, mostly stage 1, with no cases requiring dialysis. Independent predictors of AKI were younger age, elevated C-reactive protein, and ANA positivity. After a mean follow-up of 6.3 years (range 1–27.5), 23 patients (12%) developed KD (19 CKD, 4 hypertension, 2 both). Patients with AKI at onset had a significantly higher risk of KD (OR 5.8, 95% CI: 2.4–15.2; HR 3.7, 95% CI: 1.9–8.9). At 25.1 years of age, the cumulative proportion free from KD was 26.9% in patients with AKI versus 64.1% in those without (p = 0.005).

Conclusions

AKI is relatively frequent at JIA onset and represents a strong predictor of long-term kidney damage. Early recognition and careful follow-up of children with AKI may help identify those at greatest risk for adverse kidney outcomes.

Graphical abstract