{"title":"Pericardial effusion in pediatric Shiga toxin-producing E. coli hemolytic uremic syndrome: experience from an Argentinean center.","authors":"Ana Paula Spizzirri, Carlos J Cobeñas","doi":"10.1007/s00467-025-06998-6","DOIUrl":"https://doi.org/10.1007/s00467-025-06998-6","url":null,"abstract":"","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Burak Ütük, İbrahim Gokce, Neslihan Cicek, Harika Alpay
{"title":"The relationship between serum copeptin levels, peritoneal transport parameters, and bioimpedance markers in pediatric patients undergoing peritoneal dialysis.","authors":"Burak Ütük, İbrahim Gokce, Neslihan Cicek, Harika Alpay","doi":"10.1007/s00467-025-06970-4","DOIUrl":"https://doi.org/10.1007/s00467-025-06970-4","url":null,"abstract":"<p><strong>Background: </strong>The pathophysiology of hypervolemia in chronic kidney disease involves multiple mechanisms, with arginine vasopressin (AVP) playing a key role. Copeptin, a molecule located at the C-terminus of AVP, is often used as a substitute for AVP in clinical studies. In this study, we aimed to determine copeptin levels in pediatric patients with kidney failure treated by peritoneal dialysis (PD) and evaluate any possible correlation between bioimpedance parameters (BIA) and peritoneal transport parameters obtained from the peritoneal equalization test (PET).</p><p><strong>Methods: </strong>The study included 37 patients undergoing PD as the patient group and 37 healthy children of the same gender and similar age as the control group. Patients' serum and peritoneal dialysis fluid copeptin levels and PET and BIA parameters were evaluated simultaneously, and possible relationships between them were examined.</p><p><strong>Results: </strong>Serum copeptin levels in the patient group were found to be significantly higher than those in the control group (7.31 ng/ml vs. 2.55 ng/ml, p < 0.001). A negative correlation was observed between serum copeptin levels and age distribution in the control group. No relationship was found between serum copeptin levels and age or gender in the patient group. Furthermore, no significant correlation was found between serum copeptin levels and clearance values as well as transport parameters obtained by PET parameters and BIA parameters.</p><p><strong>Conclusions: </strong>Serum copeptin levels are higher in patients on PD compared to the control group. However, no significant relationship is found between serum copeptin level and BIA or PET parameters. Further studies are needed to understand more about this subject.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Incidence of and risk factors for chronic kidney disease in childhood cancer survivors.","authors":"Wataru Shimabukuro, Satoru Hamada, Hideki Sakiyama, Shinobu Kiyuna, Tokiko Oshiro, Shogo Nakada, Kazuya Hamada, Noriko Kinjo, Nobuyuki Hyakuna, Koichi Nakanishi","doi":"10.1007/s00467-025-06972-2","DOIUrl":"https://doi.org/10.1007/s00467-025-06972-2","url":null,"abstract":"<p><strong>Background: </strong>Although therapeutic advances have improved the life expectancy of children with cancer, the late complication of chronic kidney disease (CKD) represents a challenge. We aimed to measure the cumulative incidence and identify risk factors for CKD, defined as estimated glomerular filtration rate < 90 mL/min/1.73 m<sup>2</sup>, in survivors of childhood cancer.</p><p><strong>Methods: </strong>We studied children treated for cancer who survived for ≥ 5 years. The cumulative incidence of CKD was measured and risk factors were identified using the Kaplan-Meier method, the log-rank test, and Cox proportional hazards analysis.</p><p><strong>Results: </strong>Eighty-four survivors, with a median of 5.7 years old at treatment initiation, were studied for a median of 9.0 years. Nineteen, 12, 15, 57, 7 (of 78), 4, 20, 14, and 34 patients received cisplatin, carboplatin, ifosfamide, methotrexate, aminoglycoside, nephrectomy, total-body irradiation, kidney irradiation (≥ 10 Gy), and hematopoietic stem cell transplantation, respectively; and 14 developed relapse/secondary cancer. During treatment, acute kidney injury developed in 57.5% of patients. The cumulative incidence of CKD was 10.7% after 5 years and 21.8% after 10 years. The log-rank test identified older age (≥ 5 years) at treatment initiation, solid tumor, cisplatin therapy, ifosfamide therapy, and nephrectomy as significant risk factors; and a Cox proportional hazards model showed that older age (HR 3.89, p = 0.033), cisplatin therapy (HR 8.80, p < 0.001), and nephrectomy (HR 10.20, p = 0.016) were significant risk factors.</p><p><strong>Conclusions: </strong>The long-term monitoring of kidney function is especially important for survivors of childhood cancer who received their initial treatment at an older age, underwent cisplatin-based chemotherapy, or underwent nephrectomy.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heba Mostafa Ahmed, Esraa Abdelal Shafey, Rehab Muhammad Abd El Kareem, Wesam Ali Ibrahim, Osama Ezzat Botrous
{"title":"The impact of nutritional management on the growth and nutritional status of children on regular hemodialysis.","authors":"Heba Mostafa Ahmed, Esraa Abdelal Shafey, Rehab Muhammad Abd El Kareem, Wesam Ali Ibrahim, Osama Ezzat Botrous","doi":"10.1007/s00467-025-06940-w","DOIUrl":"https://doi.org/10.1007/s00467-025-06940-w","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a relatively uncommon disease in children. A child's nutritional status indicates how well their body is getting the required nutrients. This research aimed to determine the nutritional state of hemodialysis-treated children with end-stage kidney failure.</p><p><strong>Patients and methods: </strong>A case group of 50 children with kidney failure undergoing hemodialysis was compared with a control group of 50 healthy children of the same age. A structured interview questionnaire was used with the children or their mothers, covering nutritional assessment, physical examination, anthropometric measurements, and lab tests. Dietary intake was evaluated through 24-hour recalls, and each case's dietary consumption was analyzed, followed by nutritional education. Children were reassessed after a 6-month follow-up.</p><p><strong>Results: </strong>Most children with kidney failure initially had height and weight below the 5th percentile, with Mid Upper Arm Circumference (MUAC) below -3 SD. Dietary recall initially revealed low caloric intake (p = 0.046), high sodium (p = 0.06), high potassium (p = 0.01), high phosphorus (p < 0.01), and low calcium (p < 0.009) compared to controls. By study's end, MUAC and weight percentiles improved (p = 0.045 and 0.039). Lab results showed significant decreases in urea (p = 0.005), creatinine (p < 0.001), sodium (p < 0.001), potassium (p = 0.001), uric acid (p < 0.001), phosphorus (p = 0.04), and parathormone (p = 0.03) from baseline.</p><p><strong>Conclusion: </strong>Our study suggests that appropriately targeted nutrition education in children with CKD can improve weight centiles and MUAC and deranged renal biochemistry (including low serum albumin and raised serum potassium).</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mona Hamed Gehad, Doaa Mohammed Youssef, Wesam A Mokhtar, Manar M Fathy, Amal Gohary
{"title":"Unexpected Gaucher disease in a case of steroid-resistant nephrotic syndrome.","authors":"Mona Hamed Gehad, Doaa Mohammed Youssef, Wesam A Mokhtar, Manar M Fathy, Amal Gohary","doi":"10.1007/s00467-025-06991-z","DOIUrl":"https://doi.org/10.1007/s00467-025-06991-z","url":null,"abstract":"<p><p>Gaucher disease (GD), the most common lysosomal storage disorder worldwide, should be considered in children presenting with unexplained hepatosplenomegaly and cytopenia. Kidney involvement is rare, and nephrotic syndrome constitutes an uncommon complication. We describe a 15-month-old female, the first child of consanguineous parents, who initially presented with infantile nephrotic syndrome. Kidney biopsy revealed focal segmental glomerulosclerosis (FSGS). The patient had the first corticosteroid treatment without any improvement. Mycophenolate mofetil was then added, resulting in partial remission. The patient subsequently developed pancytopenia, progressive stridor, hepatosplenomegaly, and recurrent seizures. Molecular genetic testing confirmed GD. Enzyme replacement therapy (ERT) improved cytopenia, seizure control, and organomegaly, as well as uremic manifestations; however, progression to kidney failure was not reversed.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Slight acceleration in podocyte mRNA loss in preterm-born children aged 3-5 years.","authors":"Zhengqi Cui, Chao Ning, Junling Ma, Lulu Zhang, Xueou Liu, Li Kong, Ying Chang, Fangrui Ding","doi":"10.1007/s00467-025-06983-z","DOIUrl":"https://doi.org/10.1007/s00467-025-06983-z","url":null,"abstract":"<p><strong>Background: </strong>The global survival rate of preterm infants has been progressively increasing. However, concerns regarding their long-term prognosis persist. This study aimed to investigate podocyte mRNA loss in 3-5-year-old full-term and preterm children to elucidate the role of podocyte depletion in the pathogenesis of chronic kidney disease (CKD) in preterm infants.</p><p><strong>Methods: </strong>A total of 80 children aged 3-5 years, born at Tianjin Central Hospital of Gynecology and Obstetrics, were included in this study: 42 preterm infants (gestational age 24-29 weeks) and 38 full-term infants. Morning urine samples were collected to examine podocyte mRNA levels (expressed as the urinary podocin mRNA-to-creatinine ratio, UpodCR), urine protein, and urine albumin levels. The impact of perinatal factors on UpodCR was also analyzed.</p><p><strong>Results: </strong>Results indicated that the rate of podocyte mRNA loss in the preterm group was significantly higher than in the full-term group (1.54-fold). No significant differences were observed in urine protein and urine albumin levels between the two groups. Perinatal factor analysis revealed that gestational age and antenatal corticosteroid use were significant risk factors for podocyte loss in childhood.</p><p><strong>Conclusions: </strong>This study is the first to confirm accelerated podocyte loss in the urine of 3-5-year-old preterm children. Although less severe than in the early postnatal period, it remains higher than in full-term children, providing crucial evidence for the involvement of podocyte depletion in the pathogenesis of preterm-related CKD. It also underscores the need for careful evaluation of the benefits and risks associated with antenatal corticosteroid use.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Response to critical appraisal of \"Thiamin deficiency in children with chronic kidney disease on peritoneal dialysis and its association with dialysis duration and transport peritoneal membrane status\".","authors":"Phakwan Laohathai, Narumon Densupsoontorn","doi":"10.1007/s00467-025-06992-y","DOIUrl":"https://doi.org/10.1007/s00467-025-06992-y","url":null,"abstract":"","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Na Li, Ying Zhang, Lin Huang, Juanjuan Ding, Xiaowen Wang
{"title":"Clinical and prognostic characteristics of renal hypodysplasia in children: insights from a 10-year single-center cohort.","authors":"Na Li, Ying Zhang, Lin Huang, Juanjuan Ding, Xiaowen Wang","doi":"10.1007/s00467-025-06987-9","DOIUrl":"https://doi.org/10.1007/s00467-025-06987-9","url":null,"abstract":"<p><strong>Background: </strong>Renal hypodysplasia (RHD) is a common and severe form of congenital anomalies of the kidney and urinary tract (CAKUT), often leading to chronic kidney disease (CKD) in children. This study, leveraging a 10-year single-center cohort, aims to elucidate clinical and prognostic characteristics as well as genetic causes in pediatric RHD.</p><p><strong>Methods: </strong>We enrolled 322 patients diagnosed with primary RHD by ultrasound at Wuhan Children's Hospital in the past decade. Baseline and follow-up data were collected. Kidney outcomes were investigated using Kaplan-Meier curves and Cox regression model to assess risk factors for early CKD event (eGFR < 75 mL/min/1.73 m<sup>2</sup>). Whole Exome Sequencing and copy number variation analysis were performed to identify genetic causes.</p><p><strong>Results: </strong>Among 322 RHD patients, 281 (87.3%) had unilateral kidney involvement, and 41 (12.7%) had bilateral involvement. Patients with bilateral RHD exhibited worse kidney function and CKD stage (P < 0.001), while unilateral RHD was more frequently associated with additional CAKUT. After median follow-up of 4.5 years, 72 (22.4%) patients reached the early CKD endpoint. Bilateral kidney involvement (HR = 4.40, 95% CI 2.31-8.39, P < 0.001), urine ACR levels (3-30 mg/mmol: HR = 2.24, 95% CI 1.02-4.92, P = 0.044; > 30 mg/mmol: HR = 2.55, 95% CI 1.32-4.93, P = 0.005), and extra-urogenital malformations (HR = 2.28, 95% CI 1.26-4.10, P = 0.006) were independent risk factors. Genetic testing revealed PAX2, WT1 variants, and 17q12 deletion as the most prevalent pathogenic variations.</p><p><strong>Conclusions: </strong>This study reveals distinct clinical and prognostic characteristics between unilateral and bilateral RHD. Bilateral kidney lesions, albuminuria, and extra-urogenital malformations are independent risk factors for kidney function decline. PAX2, WT1 variants, and 17q12 deletion are the most common genetic causes.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jazmin D Humphreys, Aman Jain, Amir M Khan, Tina O Findley, Mar Romero-Lopez, Sepideh Saroukhani, Rita D Swinford, Matthew A Rysavy
{"title":"Urinary biomarkers of acute kidney injury in neonates < 25 weeks' gestation: a pilot study.","authors":"Jazmin D Humphreys, Aman Jain, Amir M Khan, Tina O Findley, Mar Romero-Lopez, Sepideh Saroukhani, Rita D Swinford, Matthew A Rysavy","doi":"10.1007/s00467-025-06968-y","DOIUrl":"https://doi.org/10.1007/s00467-025-06968-y","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) occurs in 30% of premature neonates and is associated with adverse outcomes that may be mitigated with early detection. Diagnosis of AKI relies on serum creatinine (SCr) which has several limitations, including lack of sensitivity and specificity. There are limited data on the utility of alternative urine biomarkers to predict AKI in neonates born at < 25 weeks' gestation.</p><p><strong>Methods: </strong>Urine was collected from neonates born at < 25 weeks' gestation during the first postnatal week. Two urine AKI biomarkers, neutrophil gelatinase-associated lipocalin (NGAL) and epidermal growth factor (EGF) were measured. Study participants were prospectively followed to determine development of AKI, defined by the neonatal modified Kidney Disease-Improving Global Outcomes (KDIGO) criteria, during the first postnatal week. The association of NGAL and EGF with AKI was analyzed using mixed-effect linear regression models adjusting for gestational age at birth.</p><p><strong>Results: </strong>A total of 26 neonates were enrolled in this study. After adjusting for gestational age at birth, the mean difference in log-transformed biomarkers at three time points for urine NGAL and EGF was not statistically different between cases and controls. Although the urinary biomarkers studied were not associated with diagnosis of AKI, AKI was associated with lower birth weight (p = 0.02).</p><p><strong>Conclusions: </strong>This study provides preliminary information about urine NGAL and EGF in neonates < 25 weeks' gestation, a growing patient population at high risk for kidney injury. The relationship between urinary biomarkers and outcomes in this population warrants further investigation.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}