Comparison of children receiving extracorporeal treatments for poisoning at United States centers with and without a pediatric nephrologist.

IF 3 3区医学 Q2 TOXICOLOGY

Clinical Toxicology Pub Date : 2025-02-06 DOI:10.1080/15563650.2025.2456109

Jon B Cole, Anne M Kouri, Joshua D King, Travis D Olives, Nathaniel L Scott, Carrie L Oakland

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引用次数: 0

Abstract

Background: Pediatric nephrologists are rare in the United States; many children with poisoning needing extracorporeal treatments may not have timely access to care. This study compared outcomes in children receiving extracorporeal treatments for poisoning at centers with and without a pediatric nephrologist.

Methods: This was a retrospective cohort study of all patients aged ≤17 years reported to an American poison center covering three upper midwestern states during 2000-2024.

Results: We identified 72 patients: 54 received extracorporeal treatments at a hospital with pediatric nephrologists, and 18 patients aged 14-17 years (minimum weight, 35 kg) received extracorporeal treatments at hospitals staffed solely by adult nephrologists. The most common responsible poisons were toxic alcohols (10/18, 55%) and salicylates (4/18, 22%). Children receiving extracorporeal treatments from adult nephrologists more commonly (P <0.001) received intermittent hemodialysis (18/18, 100%) compared to pediatric nephrologists (31/54, 57%). Conversely, children treated by pediatric nephrologists more commonly (P <0.05) received continuous kidney replacement therapy (28/54, 52%) compared to adult nephrologists (0/18). We found no difference (P = 0.1) in mortality between the children treated by pediatric nephrologists (9/54, 17%) compared to those treated by adult nephrologists (0/18).

Discussion: Teenage children commonly received hemodialysis from adult nephrologists for poisoning and had similar outcomes to those treated by pediatric nephrologists.

Conclusions: These data suggest adult nephrologists can successfully perform extracorporeal treatments for poisoning in teenage children.

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来源期刊

Clinical Toxicology 医学-毒理学

CiteScore

5.70

自引率

12.10%

发文量

148

审稿时长

4-8 weeks

期刊介绍： clinical Toxicology publishes peer-reviewed scientific research and clinical advances in clinical toxicology. The journal reflects the professional concerns and best scientific judgment of its sponsors, the American Academy of Clinical Toxicology, the European Association of Poisons Centres and Clinical Toxicologists, the American Association of Poison Control Centers and the Asia Pacific Association of Medical Toxicology and, as such, is the leading international journal in the specialty.