Pediatric Nephrology最新文献

{"title":"Investigation of normalized protein catabolic rate as a marker of nutritional status in infants and children receiving chronic hemodialysis: a longitudinal cohort study.","authors":"Nicole Salach, Celina Brunson, Anqing Zhang, Kristen Sgambat","doi":"10.1007/s00467-025-06859-2","DOIUrl":"10.1007/s00467-025-06859-2","url":null,"abstract":"<p><strong>Background: </strong>Children with kidney failure are at risk for compromised nutritional status due to a variety of challenges. Normalized protein catabolic rate (NPCR) below 1 g/kg/day has been associated with weight loss in adolescent patients on chronic hemodialysis. We sought to establish NPCR as a marker of nutritional status in patients on hemodialysis under age 13 years.</p><p><strong>Methods: </strong>A longitudinal retrospective cohort study was conducted to investigate NPCR as a marker of a composite indicator of compromised nutritional status (MINI) in infants and children (0-12 years old) who received chronic hemodialysis between 2002 and 2023. Generalized linear mixed effect models were applied to explore associations between MINI and NPCR across the study cohort (0-12 years) and after age stratification (0-3 years and 4-12 years).</p><p><strong>Results: </strong>The analysis included 758 observations of 58 patients with median age 8 (IQR 3,11) years. Compromised nutritional status was identified in 35/58 patients at 235/758 time points according to the composite definition of MINI. In children 0-12 years, NPCR < 1.2 was associated with approximately twofold increased odds of MINI (p = 0.04), adjusted for time on dialysis and Kt/V. After stratifying by age, children ages 4-12 years with NPCR < 1.2 had approximately fourfold higher odds of MINI (p = 0.003).</p><p><strong>Conclusions: </strong>NPCR < 1.2 g/kg/d was associated with a composite indicator of compromised nutritional status in this single-center retrospective analysis of the largest sample of hemodialysis patients under the age 13 to date. Multicenter studies are needed to verify these findings.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3485-3493"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476154","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":"Growth after pediatric and neonatal acute kidney injury: a meta-analysis.","authors":"Michelle C Starr, Mital Patel, Faizeen Zafar, Melissa S Zhou, Russell Griffin, Annabel Biruete, Vedran Cockovski, Rasheed Gbadegesin, Dana Y Fuhrman, Katja M Gist, Cherry Mammen, Shina Menon, Catherine Morgan, Cara L Slagle, Scott Sutherland, Michael Zappitelli, Danielle E Soranno","doi":"10.1007/s00467-025-06801-6","DOIUrl":"10.1007/s00467-025-06801-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Acute kidney injury (AKI) occurs commonly in critically ill children. The impact of AKI on pediatric growth outcomes has been sparsely described.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare growth in children with a history of AKI compared to those without AKI. We hypothesized that children with AKI would have worse growth compared to those without AKI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;A convenience sample of existing prospective and retrospective cohorts of children with AKI who had already collected or were able to collect data on growth parameters before and after an episode of AKI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study eligibility criteria: &lt;/strong&gt;There are &lt; 5 studies in the published literature on growth in children with AKI. These investigators were contacted, and additional studies were added by contacting primary investigators of studies of childhood AKI in which data on growth parameters was able to be collected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants and interventions: &lt;/strong&gt;Children from existing cohorts evaluating AKI (exposure) during childhood. Each included cohort had previously received local IRB approval per institutional guidelines. As our study was a meta-analysis and only used cohort-level data, no IRB approval was required for this report.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study appraisal and synthesis methods: &lt;/strong&gt;Growth parameters (length and weight z-scores) before and after an episode of AKI were compared using a meta-means analysis. MOOSE guidelines were used. Data were pooled using a random-effects model. Hedges g was calculated, and Higgins I&lt;sup&gt;2&lt;/sup&gt; statistic was used to define variability due to between-cohort heterogeneity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We included 3,586 children from 17 existing cohorts of AKI in various populations, including infants, children with cardiac disease, solid organ transplant and critically ill children without cardiac disease with follow-up from 12 months to 11 years after AKI. At most distant follow-up, those with AKI had lower length z-score than those without AKI (mean difference -0.37 [95%CI -0.52, -0.22, p &lt; 0.001]) and lower weight z-score (mean difference of -0.29 [95%CI -0.43, -0.15, p &lt; 0.001]). This difference was most striking in infants, as those with AKI had impaired growth (both length z-score and weight z-score) after AKI compared to those without AKI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;The analysis included only a convenience sample of observational cohorts of children, study selection could have been biased, and we did not evaluate the relationship between decreased kidney function (e.g., chronic kidney disease) after AKI in these cohorts and its relationship to poor growth.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and implications of key findings: &lt;/strong&gt;This meta-analysis found that children with AKI have impaired growth after AKI. These findings were most striking in infants. We suggest focusing on growth outcomes in both clinical care and research investigating the impact","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3379-3389"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004880","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":"Unmasking fluid overload in children on peritoneal dialysis: a multimodal diagnostic approach.","authors":"Bahriye Atmis, Ikbal Turker, Derya Cevizli, Cagla Cagli Piskin, Faruk Ekinci, Dincer Yildizdas, Aysun K Bayazit","doi":"10.1007/s00467-025-06825-y","DOIUrl":"10.1007/s00467-025-06825-y","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess fluid status in pediatric patients on peritoneal dialysis by combining ultrasonography and bioimpedance spectroscopy (BIS). It specifically focused on examining the changes in volume status following a 2-h dwell time ultrafiltration exchange and evaluating the reliability of these techniques.</p><p><strong>Methods: </strong>Thirteen pediatric patients on peritoneal dialysis were enrolled in this study, and their hydration status was assessed clinically. In addition, 56 lung ultrasound measurements, inferior vena cava (IVC) collapsibility index assessments, and BIS evaluations were performed both before and after a 2-h dwell exchange using 2.27%/2.5% dextrose dialysate.</p><p><strong>Results: </strong>The mean age of the patients was 8.6 ± 4.1 years, and eight of them (61.5%) were male. The IVC collapsibility index significantly increased (26.3 ± 10.0% vs. 44.4 ± 9.4%; p < 0.001), and the total number of B-lines significantly decreased (median 22 vs. 11.5; p < 0.001) after a 2-h dwell exchange using 2.27%/2.5% dextrose dialysate. A positive correlation was observed between the total number of B-lines and fluid overload measured using BIS both pre-dialysis (r = 0.504, p = 0.006) and post-dialysis (r = 0.528, p = 0.004). A significant reduction in the total number of B-lines was observed across all hydration groups after dialysis (p < 0.001). The area under the receiver-operating characteristic curve (AUC) for the total number of B-lines in predicting severe overhydration was 0.685 (p = 0.097) when assessed using BIS and 0.740 (p = 0.181) when assessed by weight.</p><p><strong>Conclusion: </strong>Our results highlight marked changes in fluid status parameters from pre- to post-dialysis, underscoring the clinical value of combining lung ultrasonography and BIS for monitoring fluid overload in pediatric patients undergoing peritoneal dialysis.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3505-3511"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554127","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 predicting acute kidney injury in children with septic shock: a retrospective cohort study.","authors":"Yu Fang, Weihong Zheng, Kepei Chen, Qiqi Gao, Wenwen Jin, Wei Hu, Yu Chen, Zhenlang Lin, Guoquan Pan, Wei Lin","doi":"10.1007/s00467-025-06834-x","DOIUrl":"10.1007/s00467-025-06834-x","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a prevalent and severe complication of septic shock in children, yet data on its risk factors remain scarce. This study aims to identify key predictors for AKI in this population and develop a clinical model for early risk assessment.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of clinical data from 180 children diagnosed with septic shock at a large tertiary hospital in China over 10 years. Multivariate analysis was performed to identify independent risk factors for AKI. Based on the results of the multivariate analysis, a clinical predictive nomogram for assessing the risk of sepsis-associated AKI (SA-AKI) in children with septic shock was established and validated using the \"rms\" package in R 4.3.0 software.</p><p><strong>Results: </strong>The incidence of AKI in children with septic shock was 44.4%, with significant predictors identified as greater height (95% CI 1.01-1.04), positive random proteinuria (95% CI 1.17-13.09), elevated procalcitonin levels (95% CI 1.00-1.04), base excess (95% CI 0.85-0.99), increased blood urea nitrogen levels (95% CI 1.03-1.22), and prolonged prothrombin time by ≥ 3 s (95% CI 1.13-11.43). Early use of antibiotics (95% CI 0.03-0.77) demonstrated a protective effect. The developed clinical predictive nomogram's ROC curve AUC was 0.895 (95% CI 0.836-0.955), with a sensitivity of 77.1% and specificity of 88.9%. It outperformed individual variables in predicting SA-AKI, and demonstrated good calibration and clinical utility as shown by the calibration and DCA curve. Internal validation by the bootstrap resampling method (1000 times) confirmed the model's accuracy with an AUC of 0.895 (95% CI 0.893-0.896).</p><p><strong>Conclusions: </strong>Recognizing these risk factors facilitates timely interventions for pediatric patients with septic shock. The nomogram serves as a valuable tool for clinicians, improving the management of AKI and potentially enhancing patient outcomes.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3563-3575"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266852","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":"Toward lean body weight- and ECV-based dosing of burosumab: eliminating apparent sex differences in XLH therapy.","authors":"Guido Filler, Funmbi Babalola","doi":"10.1007/s00467-025-06823-0","DOIUrl":"10.1007/s00467-025-06823-0","url":null,"abstract":"","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3585-3587"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143248","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: \"Toward better outcomes in pediatric septic shock: the role of practical risk models\".","authors":"Yu Fang, Wei Lin","doi":"10.1007/s00467-025-06927-7","DOIUrl":"10.1007/s00467-025-06927-7","url":null,"abstract":"","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3595-3596"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784949","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":"Impact of a standardized care pathway and a dedicated multidisciplinary posterior urethral valve clinic on 5-year kidney and bladder outcomes.","authors":"Mandy Rickard, Armando J Lorenzo, Cal Robinson, Samer Maher, Jin Kyu Kim, Adree Khondker, Mirriam Mikhail, Beverly Miranda, Rodrigo Romao, Joao Pippi Salle, Michael Chua, Aseel Al-Dmour, Nithiakishna Selvathesan, Joana Dos Santos","doi":"10.1007/s00467-025-06864-5","DOIUrl":"10.1007/s00467-025-06864-5","url":null,"abstract":"<p><strong>Background: </strong>Posterior urethral valves (PUV) are a rare congenital condition leading to chronic kidney disease (CKD) and bladder dysfunction. Traditional management is often reactive and non-standardized. In 2019, we implemented a dedicated multidisciplinary PUV clinic with a standardized, proactive management pathway to optimize kidney and bladder outcomes. This study evaluates its impact over 5 years.</p><p><strong>Methods: </strong>We conducted a retrospective review of our prospectively maintained PUV database, including patients diagnosed before 24 months and managed exclusively at our institution. Outcomes were compared between patients managed in the PUV clinic (aPUV) to patients before implementation (bPUV). Primary outcomes included kidney function (serum creatinine, eGFR, CKD progression, and kidney replacement therapy). Secondary outcomes assessed bladder function, including medications, catheterization, and urinary tract infections.</p><p><strong>Results: </strong>A total of 196 patients were analyzed (bPUV: 133; aPUV: 63). The aPUV cohort had earlier interventions and a higher rate of primary urinary diversion (54% vs. 11%; p < 0.01). The aPUV group had lower nadir serum creatinine (21 vs. 29 μmol/l; p < 0.01), reduced CKD progression (12% vs. 27%; p = 0.02), and fewer patients requiring kidney replacement therapy (3% vs. 20%; p < 0.01). Earlier bladder therapy initiation led to reduced hydronephrosis and timelier catheterization.</p><p><strong>Conclusion: </strong>A standardized PUV clinic and proactive management approach significantly improved kidney and bladder outcomes at 5 years. If sustained, this strategy may delay CKD progression and reduce the need for kidney replacement therapy. Longer follow-up is needed to assess long-term impact.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3459-3467"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485369","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":"Practice variation in the use of steroid-sparing therapies in childhood steroid-sensitive nephrotic syndrome: results from a prospective cohort study.","authors":"Angie Aguilar-González, Ava Zardynezhad, Catherine Morgan, Allison Dart, Cherry Mammen, Rulan S Parekh, Pavel Geier, Genevieve Benoit, Guido Filler, Janusz Feber, James Tee, Steven Arora, Damien Noone, Silviu Grisaru, Rahul Chanchlani, Augustina Okpere, Susan Samuel","doi":"10.1007/s00467-025-06853-8","DOIUrl":"10.1007/s00467-025-06853-8","url":null,"abstract":"<p><strong>Background: </strong>Steroid-sparing therapies are often used to prolong disease remission while minimizing steroid toxicity in childhood steroid-sensitive nephrotic syndrome (SSNS). This study aims to describe practice variation in the use of steroid-sparing medications for childhood SSNS in Canada.</p><p><strong>Methods: </strong>Children (1-18 years) with nephrotic syndrome (NS) from eleven pediatric nephrology centers in Canada were enrolled in the Canadian Childhood Nephrotic Syndrome (CHILDNEPH) prospective cohort from 2013-2019. Data, including time to first relapse for children treated with cyclophosphamide, tacrolimus, mycophenolate mofetil, cyclosporine and rituximab were analyzed using summary statistics. Participants who received steroid-sparing therapies prior to enrolment were excluded.</p><p><strong>Results: </strong>Of the 371 children enrolled, 321 (86.5%) had SSNS and 133 met the study criteria. Median age at enrollment was 3.0 years (IQR: 2.0-6.3). Median follow-up period was 3.0 years (IQR 1.0-4.0). Timing of initiation and choice of steroid-sparing therapy varied across centers. The majority (72.2%) initiated therapies after a median of 3 relapses (IQR: 2-4). Cyclophosphamide and tacrolimus were the most frequently used initial therapies at 39.1% and 23.3%, respectively. Thirty (22.6%) patients switched to a second medication after a median time of 4 months (IQR 0.25-11); of which, 40% switched from either cyclophosphamide or mycophenolate mofetil to tacrolimus. There were no statistically significant differences in time to first relapse with initial therapies (log rank P-value 0.36).</p><p><strong>Conclusions: </strong>Significant variation in the use of steroid-sparing therapies exists in the treatment of SSNS. A clinical trial is needed to examine the efficacy of these medications to optimize treatment and decrease practice variation.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3437-3445"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541801","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":"Evaluation of acute kidney injury in preterm infants using serum creatinine decline in comparison with KDIGO criteria.","authors":"Yoong-A Suh, Seong Wan Kim, Seoheui Choi, Jang Hoon Lee, Moon Sung Park, Peong Gang Park","doi":"10.1007/s00467-025-06855-6","DOIUrl":"10.1007/s00467-025-06855-6","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is commonly observed in critically ill neonates; however, early identification of AKI in the first week of life is challenging due to the influence of maternal serum creatinine (SCr). An alternative criterion proposed by Gupta et al. based on SCr decline may identify additional infants at risk beyond the KDIGO definition.</p><p><strong>Methods: </strong>We retrospectively reviewed 409 infants with a gestational age < 32 weeks who were admitted to our NICU between 2018 and 2024. AKI was defined according to the KDIGO guidelines or the Gupta threshold for days 3, 5, or 7 SCr. We compared mortality, bronchopulmonary dysplasia (BPD), and length of hospital stay among the No-AKI, Gupta-only AKI, and KDIGO-AKI groups.</p><p><strong>Results: </strong>Among 409 infants, 145 (35.5%) had Gupta-only AKI, 9 (2.2%) had KDIGO-only AKI, and 54 (13.2%) had both definitions. The infants with AKI were premature and had lower birth weights than those without AKI. Both AKI groups showed higher rates of composite outcomes (mortality or BPD) than the No-AKI (p < 0.001) group. Gupta-only AKI was associated with prolonged stay (+ 10.1 days, p = 0.01) and increased odds of BPD (adjusted OR 2.12, p = 0.023), while KDIGO-AKI had a stronger association with mortality (27.0%, p < 0.001).</p><p><strong>Conclusions: </strong>The Gupta definition identified a substantial subset of highly preterm infants at a higher risk of adverse outcomes who were missed using the KDIGO criteria. Integrating SCr level decline-based methods may improve early AKI detection and enhance outcomes in this vulnerable population.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3521-3528"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294760","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":"Dysnatremias in pediatric victims of the 2023 Türkiye-Syria earthquake.","authors":"Ulas Ozdemir, Tugba Kandemir Gulmez, Mehmet Deniz Erhan, Umit Celik, Sevgin Taner","doi":"10.1007/s00467-025-06843-w","DOIUrl":"10.1007/s00467-025-06843-w","url":null,"abstract":"<p><strong>Background: </strong>Dysnatremia is a common electrolyte abnormality in children, but its prevalence and impact in pediatric earthquake victims are not well established. This study aimed to define the frequency of dysnatremia in pediatric earthquake victims and evaluate its relationship with complications, mortality, and morbidity.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 312 pediatric patients admitted to our hospital after the 2023 Türkiye-Syria earthquakes. Patients were categorized based on admission sodium levels: hyponatremic (< 135 mmol/L), hypernatremic (> 145 mmol/L), and normal (135-145 mmol/L). Demographic, clinical, and laboratory data were analyzed.</p><p><strong>Results: </strong>Of the 312 patients, 36.2% were hyponatremic, 17.3% were hypernatremic, and 46.5% had normal sodium levels. The frequency of fasciotomy, crush syndrome (CS), acute kidney injury (AKI), and dialysis treatment was significantly higher in the hyponatremic patient group compared to those with normal sodium levels (p < 0.001). Hypernatremic patients also had a longer time under the rubble at 121 ± 64 h, compared to 35 ± 41 h in patients with normal sodium (p < 0.001). Mortality was 5.4%, with no significant difference between dysnatremic and normonatremic patients.</p><p><strong>Conclusions: </strong>Dysnatremia is common in pediatric earthquake victims. Dysnatremia is associated with increased morbidity, including CS and AKI. Monitoring and management of sodium abnormalities are crucial in the care of pediatric earthquake survivors.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3529-3537"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512268","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}