Frontiers in Pediatrics最新文献

{"title":"Genotype-phenotype insights of pediatric dilated cardiomyopathy.","authors":"Ying Dai, Yan Wang, Youfei Fan, Bo Han","doi":"10.3389/fped.2025.1505830","DOIUrl":"10.3389/fped.2025.1505830","url":null,"abstract":"<p><p>Dilated cardiomyopathy (DCM) in children is a severe myocardial disease characterized by enlargement of the left ventricle or both ventricles with impaired contractile function. DCM can cause adverse consequences such as heart failure, sudden death, thromboembolism, and arrhythmias. This article reviews the latest advances in genotype and phenotype research in pediatric DCM. With the development of gene sequencing technologies, considerable progress has been made in genetic research on DCM. Research has shown that DCM exhibits notable genetic heterogeneity, with over 100 DCM-related genes identified to date, primarily involving functions such as calcium handling, the cytoskeleton, and ion channels. As human genomic variations are linked to phenotypes, DCM phenotypes are influenced by numerous genetic variations across the entire genome. Children with DCM display high genetic heterogeneity and are characterized by early onset, rapid disease progression, and poor prognosis. The genetic architecture of pediatric DCM markedly differs from that of adult DCM, necessitating analyses through clinical phenotyping, familial cosegregation studies, and functional validation. Clarifying the genotype-phenotype relationship can improve diagnostic accuracy, enhance prognosis, and guide follow-up treatment for genotype-positive and phenotype-negative patients identified through genetic testing, providing new insights for precision medicine. Future research should further explore novel pathogenic genes and mutations and strengthen genotype-phenotype correlation analyses to facilitate precise diagnosis and treatment of DCM in children.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1505830"},"PeriodicalIF":2.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrative review of the literature on the pediatric orthopedic management of fibrous dysplasia.","authors":"Elio Paris, Giacomo De Marco, Oscar Vazquez, Christina Steiger, Sana Boudabbous, Romain Dayer, Dimitri Ceroni","doi":"10.3389/fped.2024.1502262","DOIUrl":"10.3389/fped.2024.1502262","url":null,"abstract":"<p><p>Fibrous dysplasia is a congenital, non-inherited, benign intramedullary bone lesion in which the normal bone marrow is replaced by abnormal fibro-osseous tissue. The disorder can be monostotic (involving a single bone) or polyostotic (involving multiple bones). As the abnormal fibro-osseous tissue compromises the mechanical strength of bone, it can result in pain, deformity, fractures, or abnormalities in bone mechanics with inappropriate bone alignment. This narrative review attempts to summarize more than 20 years of observations of patients with FD to help pediatric orthopedists establish a care framework that can improve its identification, understand the impact that endocrinopathies can have on its clinical presentation, and optimize the management of bone disorders. Our focus is specifically on orthopedic manifestations of FD and modern management alternatives. The past 20 years have provided major advances in understanding of fibrous dysplasia (FD), and it is clear that the pediatric orthopedist's role remains highly relevant in the management of all types of FD. Surgical treatment remains appropriate when pain is unresponsive to other medical treatments, when a pathological fracture is impending or has happened, when a deformity is worsening or has formed, or when there is a suspicion of malignant transformation. The pediatric orthopedist must be aware, therefore, of the particularities of the different bones on which they may be called to intervene, and they should give very careful consideration to their operative strategy, which must be adjusted to the biological and static characteristics of the bone.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"12 ","pages":"1502262"},"PeriodicalIF":2.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The growth diversity of preterm infants at 0-36 months corrected age in China: a real-world observational study.","authors":"Xia Wang, Shuwen Feng, Pu Yang, Yuxin Wang, Cong Wei, Junwen Zheng, Pin Liu, Lihong Liao, Xiao Yang, Peibin Xu, Junmei Bian, Xiaoping Luo, Yuanzhen Zhang, Dongchi Zhao","doi":"10.3389/fped.2025.1506244","DOIUrl":"10.3389/fped.2025.1506244","url":null,"abstract":"<p><strong>Background: </strong>Premature delivery interrupts the natural growth of the fetus. The postnatal healthy management of preterm infants still follows term standards after a postmenstrual age (PMA) of 40 weeks and there is a lack of research on the longitudinal dynamic postnatal growth tracks of preterm infants.</p><p><strong>Methods: </strong>Based on the database established by the Wuhan University Internet+ Early Childhood Development Alliance in China, information on preterm infants, including birth registration and health follow-ups from 2016 to 2022, was incorporated into the health management system. Standardized anthropometric measurements of preterm infants were recorded from birth to a corrected age (CA) of 36 months. A generalized additive model based on location, scale, and shape was used to establish the percentile values and growth curves.</p><p><strong>Results: </strong>In total, 79,514 preterm infants were included in this study, and the birth weights at each gestational age (GA) were similar to Chinese standards. When evaluated by term birth weight, we found that the proportions of extrauterine growth retardation at a PMA of 40 weeks were all above 10% in the GA ≤34-week groups and reached between 17.19% and 55.56% in very preterm infants (VPIs). There was a high incidence of preterm infants with a weight below the third percentile in VPIs when referring to term standards at CAs of 0, 6, 12, 24, and 36 months (<i>p</i> < 0.001). We established natural growth curves of the preterm population with different GAs between CAs of 0 and 36 months, which indicated that the weight/length of late preterm infants was close to term standards while the growth trajectory of VPIs consistently lagged behind (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Our study revealed the different growth trajectories of preterm infants with different GAs. A set of growth curves and percentile values for preterm infants of different GAs between CAs of 0 and 36 months were established, offering an optional method for growth assessment of this special population.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1506244"},"PeriodicalIF":2.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: severe pulmonary hypertension in a child with micronutrient deficiency.","authors":"Laure Pache-Wannaz, Cristiana Voicu, Laurence Boillat, Nicole Sekarski","doi":"10.3389/fped.2025.1478889","DOIUrl":"10.3389/fped.2025.1478889","url":null,"abstract":"<p><p>We describe the rare case of a previously healthy seven year-old boy, with an acute clinical onset of severe pulmonary hypertension. He recovered rapidly after vitamin supplementation. Patient history showed a highly selective food intake in the context of autistic features. Thiamine deficiency seemed to be the predominant causing factor aggravated by moderate iron deficiency and supposed vitamin C deficiency. Dietary impact on pulmonary pressures is still poorly understood, but it seems that micronutrient deficiency could be a rare cause of pulmonary hypertension. Relatively frequent in developing countries and mostly in infants, thiamine deficiency should not be forgotten as a potential etiology in the differential diagnosis when patient dietary history is particular.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1478889"},"PeriodicalIF":2.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Necrotizing pneumonia in pediatric patients: a rare case of unilateral necrosis in two entire lobe tissues.","authors":"Jingli Zhang, Yingqian Zhang, Longfei Gao, Huifang Wu, Xiaojuan Liu, Fan Yang, Yingxue Wang","doi":"10.3389/fped.2024.1428402","DOIUrl":"10.3389/fped.2024.1428402","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing pneumonia is a serious complication of <i>Mycoplasma pneumoniae</i> infection, especially in pediatric patients. Although necrotizing pneumonia is a rare condition, the occurrence of unilateral necrosis in two entire lobe tissues is even rarer. This case study presents a 5-year-old male child with necrotizing pneumonia caused by <i>Mycoplasma pneumoniae</i>, describing the clinical features, laboratory abnormalities, and radiographic findings associated with this condition, particularly the rare occurrence of unilateral necrosis in two entire lobe tissues.</p><p><strong>Case presentation: </strong>The patient presented with a 14-day history of fever and cough, accompanied by paroxysmal cough with continuous sounds, congested throat, increased respiratory effort, and abnormal lung findings on physical examination. Laboratory investigations revealed elevated white blood cell count, increased inflammatory markers, elevated liver enzymes, coagulation dysfunction, and hypoalbuminemia. Imaging studies showed the presence of pleural effusion and progressive necrotizing pneumonia, including the rare occurrence of unilateral necrosis affecting both entire lobe tissues.</p><p><strong>Conclusion: </strong>Necrotizing pneumonia caused by <i>Mycoplasma pneumoniae</i> infection can present with prolonged fever, elevated inflammatory markers, pleural effusion, and progressive necrosis of lung tissue, with the occurrence of necrosis observed unilaterally in both entire lobe tissues is even rarer. Monitoring D-dimer levels is essential for evaluating the possibility of necrotizing pneumonia. Early recognition and appropriate management are crucial to improve outcomes in these patients.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"12 ","pages":"1428402"},"PeriodicalIF":2.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the gap in preterm resuscitation practices in high-income and low-middle income countries: a multicenter survey of the Asian neonatal network collaboration.","authors":"Rinawati Rohsiswatmo, Rizalya Dewi, Jennie Sutantio, Zubair Amin, Young-Ah Youn, Sae Yun Kim, Su Jin Cho, Yun Sil Chang, Satoshi Kusuda, Fuyu Miyake, Tetsuya Isayama","doi":"10.3389/fped.2024.1517843","DOIUrl":"10.3389/fped.2024.1517843","url":null,"abstract":"<p><strong>Background: </strong>Optimum neonatal resuscitation practices are vital for improving neonatal survival and neurodevelopment outcomes, particularly in extremely preterm infants. However, such practices may vary between high-income countries (HICs) and low-middle-income countries (LMICs). This study aimed to evaluate the resuscitation practices of high-risk infants in a large multi-country sample of healthcare facilities among HICs and LMICs in Asia under the AsianNeo Network.</p><p><strong>Methods: </strong>In 2021, a customized 6-item online survey on resuscitation practices of infants born at <29 weeks gestation (or birth weight <1,200 g) was sent by the representative of each country's neonatal network to all the Neonatal Intensive Care Units (NICUs) participating in AsianNeo network. At the time of the survey, there were 446 participating hospitals in eight countries: four high-income countries (Japan, Singapore, South Korea, and Taiwan) and four low-middle-income countries (Malaysia, Indonesia, Philippines, and Thailand).</p><p><strong>Results: </strong>The study included 446 hospitals, with a response rate of 72.6% (ranging from 62.7% to 100%), with 179 (55.2%) in HICs and 145 (44.7%) in LMICs. Routine attendance of experienced NICU physicians during resuscitations is reported to be higher in HICs than LMICs, both during daytime (79% vs. 40%) and nighttime (62% vs. 23%). The NRP guidelines in each country were varied, with 4 out of 8 countries using indigenously developed guidelines. Equipment availability during resuscitation was also variable; saturation monitors, radiant warmers, and plastic wraps were available in almost all hospitals, whereas oxygen and air blenders, heated humidified gas, and end-tidal CO₂ detectors were more available in HICs. The most common device for Positive Pressure Ventilation (PPV) was the T-piece resuscitator (52.3%).</p><p><strong>Conclusion: </strong>The neonatal resuscitation practices for extremely preterm infants, encompassing staff, equipment, and guidelines, exhibited variance between HICs and LMICs in the AsianNeo region. Further enhancements are imperative to narrow this gap and optimize neonatal outcomes.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"12 ","pages":"1517843"},"PeriodicalIF":2.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for malignancy in pediatric subacute/chronic focal craniocervical lymphadenopathy.","authors":"Yishai Haimi-Cohen, Eyal Elron, Lital Oz-Alcalay, Lama Hejly, Roy Hod, Liat Ashkenazi-Hoffnung","doi":"10.3389/fped.2024.1466116","DOIUrl":"10.3389/fped.2024.1466116","url":null,"abstract":"<p><strong>Aims: </strong>To describe the factors associated with malignancy in otherwise healthy children with focal persistent isolated craniocervical lymphadenopathy at low risk for malignancy, in order to aid in decisions of nodal surgical excision.</p><p><strong>Material and methods: </strong>Demographic and clinical data were retrospectively obtained for children with subacute and chronic craniocervical lymphadenopathy, treated from January 2008 to December 2020 at a general pediatric ambulatory clinic of a tertiary center. Univariate and multivariate analyses of risk factors for malignancy were performed.</p><p><strong>Results: </strong>Of the 450 children included, median age 4.2 years (interquartile age: 2.4-8.7), 25 (5.6%) were eventually diagnosed with a malignancy. In univariate analysis, factors associated with malignancy included older age, increased nodal size, location (supraclavicular and lateral cervical), systemic signs such as decreased appetite and weight loss, and abnormal imaging studies. Referral by an ear, nose, throat specialist vs. a family physician or a pediatrician was also associated with malignancy. Fever, night sweats, pruritus, hepatosplenomegaly and laboratory workup were not associated with malignancy. Twenty percent of the children older than 12.5 years and 12% of those with a lymph node diameter >31 mm were diagnosed with malignancy. Multivariate analysis showed associations with malignancy of older age and larger lymph nodes; the respective odds ratios were 1.649 (95%CI: 1.197-2.349, <i>p</i> = 0.004) for every 3 years and 2.080 (95%CI: 1.292-3.330, <i>p</i> = 0.002) for every one centimeter.</p><p><strong>Conclusions: </strong>Older age and increased nodal size can help identify children with focal craniocervical lymphadenopathy who are at increased risk for malignancy and for whom surgical intervention should be strongly considered.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"12 ","pages":"1466116"},"PeriodicalIF":2.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic value and efficacy evaluation of lung ultrasound score in neonatal respiratory distress syndrome: a prospective observational study.","authors":"Jian Dong, Yuhong Deng, Jin Tong, Tingting Du, Wenguang Liu, Yan Guo","doi":"10.3389/fped.2025.1500500","DOIUrl":"10.3389/fped.2025.1500500","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic efficacy and determine the optimal cut-off values of lung ultrasound score for diagnosing neonatal respiratory distress syndrome and its accuracy in assessing the efficacy of neonatal respiratory distress syndrome.</p><p><strong>Method: </strong>This prospective study included 100 neonates with suspected neonatal respiratory distress syndrome. Each patient underwent both the 14-zone and 12-zone lung ultrasound methods, as well as a chest x-ray, performed after birth and before initiating drug treatment. Surfactant replacement therapy was administered to patients who were diagnosed with neonatal respiratory distress syndrome and met the criteria for medication. Lung ultrasound was conducted and recorded at the 24th hour, the 48th hour, the 72nd hour, and the 7th day after drug administration. ROC curve analysis, Kappa statistics, and ANOVA were utilized to identify the optimal cut-off values for the lung ultrasound scores in diagnosing neonatal respiratory distress syndrome.</p><p><strong>Results: </strong>89 neonates were diagnosed with respiratory distress syndrome, of whom 64 received surfactant replacement therapy. The mean scores of 12-zone lung ultrasound score, 14-zone lung ultrasound score, and chest x-ray score are 18.22 ± 7.15, 38.92 ± 9.69, and 2.15 ± 0.97, respectively. The diagnostic AUC for the 12-zone lung ultrasound score is 0.84 (95% CI: 0.73-0.95), with an optimal cut-off value of 13.5 for diseased vs. not diseased, while the AUC for the 14-zone lung ultrasound score is 0.88 (95% CI: 0.76-0.99), with an optimal cut-off value of 34 for diseased vs. not diseased. There is significant concordance between the neonatal lung ultrasonography scores and the chest x-ray score for diagnosis respiratory distress syndrome (<i>P</i> < 0.01). The optimal cut-off values for the grading diagnosis of neonatal respiratory distress syndrome using the 14-zone lung ultrasound score are identified as 36.5, 40.5, and 44.5. The 12-zone lung ultrasound score does not have a significant difference between the 12th hour after receiving surfactant replacement therapy and the 48th hour after treatment (<i>P</i> = 0.08). All other comparisons demonstrated significant differences.</p><p><strong>Conclusion: </strong>The 14-zone lung ultrasound score demonstrates higher diagnostic efficacy in diagnosing neonatal respiratory distress syndrome and can accurately evaluate the early efficacy of surfactant replacement therapy in neonates.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1500500"},"PeriodicalIF":2.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The consistency and efficacy of optical coherence tomography for the evaluation of ocular torsion angle in children.","authors":"Rongjun Liu, Jingjing Zhao, Kaili Yu, Dehai Zhu","doi":"10.3389/fped.2025.1519017","DOIUrl":"10.3389/fped.2025.1519017","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the consistency and efficacy of optical coherence tomography (OCT) for the evaluation of ocular torsion angle compared to fundus photography in children.</p><p><strong>Method: </strong>Patients who had undergone fundus photography and OCT within 1 day were included in this study. The fundus photographs were taken using a fundus camera and then imported into the Adobe Photoshop 2021 software. The fovea-disc angle (FDA) was calculated manually. OCT was used to automatically detect the centers of the optic disc and fovea, and the software then calculated the FDA on the same device. The means and ranges of variables were calculated in this study. Group differences were assessed using the paired <i>t</i>-test. Statistical significance was determined when <i>P</i>-values were <0.05. Bland-Altman plots were constructed to verify the agreement of the FDAs measured by fundus photography and OCT respectively.</p><p><strong>Results: </strong>A total of 100 patients were included and the objective measurements of the ocular torsion angles via OCT and fundus photography were similar. The mean FDA of 32 patients aged 2-6 years old was -7.84 ± 4.67° via fundus photography and -6.71 ± 6.19° via OCT. The mean FDA of 68 patients aged 6-18 years old was -8.47 ± 5.22° via fundus photography and -8.97 ± 5.41° via OCT. According to the receiver operational characteristic (ROC) curves of the FDA for diagnosing ocular extorsion, the area under the ROC curve was greatest for OCT (0.943, 95% CI: 0.902-0.984), followed by fundus photography (0.92, 95% CI: 0.86-0.979). With the Youden method, the optimal cut-off point for diagnosing ocular extorsion with OCT was -6.35°. OCT demonstrated a sensitivity of 100% and a specificity of 49.2%. Furthermore, the optimal cut-off point for diagnosing ocular extorsion with fundus photography was -6.5°.</p><p><strong>Conclusion: </strong>The comparison of FDAs showed good agreement between fundus photography and OCT. Thus, OCT can evaluate ocular torsion angle effectively in children.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1519017"},"PeriodicalIF":2.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium glucose co-transporter 2 inhibitors (SGLT2i) for pediatric kidney disease: the future is near.","authors":"Gilda M Portalatin, Irene Hong-McAtee, Anna M Burgner, Edward R Gould, Tracy E Hunley","doi":"10.3389/fped.2025.1521425","DOIUrl":"10.3389/fped.2025.1521425","url":null,"abstract":"<p><p>The sodium glucose co-transporter 2 (SGLT2) functions in the proximal tubule to reabsorb the bulk of filtered glucose. SGLT2 inhibitors have been developed to promote renal glucose excretion to improve glycemic control in diabetes. Regulatory guidance mandated adequately powered studies to detect increased cardiovascular risk from emerging hypoglycemic medications. This led to recognition of remarkable improvement in cardiovascular and kidney outcomes with SGLT2 inhibition. Moreover, cardiovascular and kidney benefits extend beyond patients with diabetes. The dramatic kidney benefits of SGLT2 inhibitors documented in CKD in adult patients underscores the need for pediatric nephrologists to familiarize themselves with SGLT2 inhibitor therapies. This review explores the currently available body of knowledge regarding the kidney protective effects of SGLT2 inhibitors in adults and mechanisms thought to contribute to improved kidney outcomes. The limited data for SGLT2i treatment in pediatric kidney disease are reviewed and highlight the need for randomized controlled trials of this drug class in pediatric kidney patients as has been done for pediatric diabetes. Dosing patterns for SGLT2 inhibitors from other pediatric settings are reviewed as well as guidance for initiating SGLT2 inhibition in young adults remaining in pediatric nephrology care.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1521425"},"PeriodicalIF":2.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}