Kidney Involvement in Multisystem Inflammatory Syndrome-C: A Pediatric Nephrologist’s Perspective

Sethi, Sidharth Kumar; Rana, Abhyuday; Adnani, Harsha; McCulloch, Mignon; Alhasan, Khalid; Sultana, Azmeri; Safadi, Rama; Agrawal, Nirav; Raina, Rupesh

The initial report of the multisystem inflammatory syndrome (MIS-C) in children was from the United Kingdom in April 2020; since then, cases have been reported worldwide. Renal involvement has been seen commonly, ranging from 10% to 46%. Kidney involvement following SARS-CoV-2 infection in children with MIS-C is more common than initially thought and is associated with higher morbidity and mortality. There are several reports of a direct viral tropism of COVID-19 and MIS-C associated renal damage. This study's objective was to systematically review the current understanding of kidney involvement in children suffering from MIS-C. Based on our systemic literature search, 19 studies have either partially or fully discussed kidney involvement in MIS-C patients. Furthermore, we discuss the multifactorial pathogenesis contributing to AKI development in MIS-C. Conclusion: The current review gives a Pediatric Nephrologist's perspective of the renal involvement in MIS-C, the incidence of Acute Kidney Injury (AKI), the pathophysiology of AKI in MIS-C, and the proposed therapeutic regimens available, including the need for Kidney replacement therapy for a child with AKI associated with MIS-C. As the disease is rapidly evolving, more detailed clinical prospective studies are required to understand MIS-C and its role in AKI better.