Pediatric Nephrology最新文献_第3页

Risk factors for perinatal and neonatal mortality in cases with congenital anomalies of the kidney and urinary tract: a nested cohort study. 先天性肾脏和尿路异常患者围产期和新生儿死亡率的危险因素：一项嵌套队列研究。

IF 2.6 3区医学

Pediatric Nephrology Pub Date : 2025-12-01 Epub Date: 2025-08-09 DOI: 10.1007/s00467-025-06922-y

Rodrigo R Arantes, Marcos B Aguiar, Keyla C C M S Cunha, Arthur A Amaral, José Renato O Melo, Beatriz Chaves C Vieira, Enrico A Colosimo, Eduardo A Oliveira, Ana Cristina Simoes E Silva

{"title":"Risk factors for perinatal and neonatal mortality in cases with congenital anomalies of the kidney and urinary tract: a nested cohort study.","authors":"Rodrigo R Arantes, Marcos B Aguiar, Keyla C C M S Cunha, Arthur A Amaral, José Renato O Melo, Beatriz Chaves C Vieira, Enrico A Colosimo, Eduardo A Oliveira, Ana Cristina Simoes E Silva","doi":"10.1007/s00467-025-06922-y","DOIUrl":"10.1007/s00467-025-06922-y","url":null,"abstract":"Background: We aimed to investigate predictive factors associated with perinatal and neonatal mortality in cases with congenital anomalies of the kidney and urinary tract (CAKUT).Methods: This study included a cohort of neonates with CAKUT born at a tertiary hospital between 1996 and 2021. Controls were matched with CAKUT cases by sex, time, and place of birth at a ratio of approximately 2:1. The covariates included in the analysis were sex, gestational age, birth weight, neonatal classification, and birth order. CAKUT was categorized into four phenotypes: urinary tract dilatation, lower urinary tract obstruction (LUTO), cystic diseases, and agenesis/hypodysplasia. The primary outcome was perinatal and neonatal mortality. Survival analysis was performed using the Cox proportional hazards model.Results: 857 cases and 1,755 controls were included in the analysis. The overall early mortality rate was 7.2%. After controlling for confounding factors, CAKUT cases exhibited a higher risk of perinatal and neonatal mortality than controls (hazard ratio [HR], 25.1; 95%CI, 14.0-45.2). The following covariates were independently associated with mortality: prematurity (HR, 1.7; 95%CI, 1.2-2.5), LBW (HR, 2.4; 95%CI, 1.6-2.5), VLBW (HR, 2.9; 95%CI, 1.1-1.7), oligohydramnios (HR, 3.2; 95%CI, 2.2-4.8), cystic diseases (HR, 3.8; 95%CI, 2.3-6.4), LUTO (HR, 5.1; 95%CI, 3.0-8.5), kidney agenesis/hypodysplasia (HR, 5.1; 95%CI, 2.9-8.7), and extra-renal malformations (HR, 2.6; 95% CI, 1.7-3.9).Conclusions: CAKUT was associated with elevated stillbirth and neonatal mortality rates compared with controls. Prematurity, LBW, oligohydramnios, extra-renal malformations, and specific CAKUT phenotypes with kidney involvement were associated with increased mortality risk.","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3697-3705"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812220","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}

引用次数: 0

Post-hurricane fluid conservation measures fail to reduce IV fluid use in critically ill children. 飓风后液体保护措施未能减少危重儿童的静脉输液使用。

IF 2.6 3区医学

Pediatric Nephrology Pub Date : 2025-12-01 Epub Date: 2025-08-19 DOI: 10.1007/s00467-025-06931-x

Celeste G Dixon, James D Odum, Ulka Kothari, Susan D Martin, Julie C Fitzgerald, Ami Shah, Heda Dapul, Chloe G Braun, Andrew Barbera, Nina Terry, Scott L Weiss, Denise C Hasson, Adam C Dziorny

{"title":"Post-hurricane fluid conservation measures fail to reduce IV fluid use in critically ill children.","authors":"Celeste G Dixon, James D Odum, Ulka Kothari, Susan D Martin, Julie C Fitzgerald, Ami Shah, Heda Dapul, Chloe G Braun, Andrew Barbera, Nina Terry, Scott L Weiss, Denise C Hasson, Adam C Dziorny","doi":"10.1007/s00467-025-06931-x","DOIUrl":"10.1007/s00467-025-06931-x","url":null,"abstract":"Background: There are risks associated with excessive intravenous fluid (IVF) administration in critically ill children. Previous efforts have described opportunities to reduce positive cumulative fluid balance (CFB) in this population but have not been widely implemented. In the wake of Hurricane Helene, a national IVF shortage led to the implementation of IVF conservation guidelines. We sought to determine if this was associated with a reduction in IVF use and CFB.Methods: The present study is a four-site cohort study of critically ill children utilizing a federated data collection framework to extract patient age, sex, weight, and daily fluid intake/output for days 1-4 of all admissions 28 days prior to and 28 days after the implementation of IVF conservation guidelines. Guidelines were individualized per institution. Total fluid intake, total IVF intake, % intake from IVF, and % CFB were compared between pre- and post-IVF conservation groups.Results: All sites had similar conservation recommendations. There were 633 patients admitted pre- and 619 patients admitted post-IVF conservation guideline implementation, with similar age and weight distributions. There was no significant difference in IVF use pre- and post-IVF conservation; 29-35% of patients had > 5% CFB on day 1 pre-IVF conservation while 27-39% did post-conservation, with increasing numbers on day 2.Conclusions: Even in the setting of a national IVF shortage, simple recommendations without structured change were insufficient to change IVF administration practices. This indicates additional practices will be needed to reduce IVF intake and % CFB in this vulnerable population.","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3825-3830"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874430","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}

引用次数: 0

Acute kidney injury in children and adolescents admitted for pneumonia in the Philippines. 菲律宾因肺炎入院的儿童和青少年急性肾损伤

IF 2.6 3区医学

Pediatric Nephrology Pub Date : 2025-12-01 Epub Date: 2025-08-04 DOI: 10.1007/s00467-025-06899-8

Ena Lauren F Farillas, Melissa A Dator

{"title":"Acute kidney injury in children and adolescents admitted for pneumonia in the Philippines.","authors":"Ena Lauren F Farillas, Melissa A Dator","doi":"10.1007/s00467-025-06899-8","DOIUrl":"10.1007/s00467-025-06899-8","url":null,"abstract":"Background: Acute kidney injury (AKI) in children increases the risk of adverse outcomes, and its incidence is higher in low- and middle-income countries-with infectious and diarrheal diseases greatly contributing to its development. The incidence of AKI in patients with pneumonia is poorly described in the literature. This study determined the clinical profile of AKI among children with pneumonia at the emergency department in a university hospital in the Philippines.Methods: Records of 306 patients aged 1 month to 18 years with pneumonia were retrospectively analyzed. The patients were divided into two groups based on the presence of AKI using the Kidney Disease Improving Global Outcomes creatinine-based criteria. Clinicodemographic, laboratory, and outcome parameters were compared between groups. Logistic regression analysis was performed to identify predictors of AKI.Results: Prevalence of AKI was 19.28%. Moderate-severe dehydration [OR 2202.71, 95% CI 135.37, 35,841.88; p < 0.0001] and need for intubation [OR 25.04, 95% CI 6.7, 93.52; p < 0.0001] were the strongest predictors for AKI. Other identified predictors included: age 10 to < 19 years, preterm birth, severe wasting, overweight/obesity, and leukocytosis.Conclusions: The burden of AKI in our population, especially stage 3 AKI, is substantial and leads to significant morbidity and mortality. There are multiple factors associated with its development among pediatric patients with pneumonia, and early identification and improved surveillance of those at risk are crucial in reducing the increased morbidity and mortality associated with its occurrence.","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3803-3813"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784946","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}

引用次数: 0

Are the outcomes of critically ill children undergoing pediatric continuous kidney replacement therapy actually modifiable? 危重儿童接受儿科持续肾替代治疗的结果是否可以改变？

IF 2.6 3区医学

Pediatric Nephrology Pub Date : 2025-12-01 Epub Date: 2025-06-05 DOI: 10.1007/s00467-025-06836-9

Francesco Guzzi, Zaccaria Ricci

引用次数: 0

Comment on: Erythropoietin resistance among pediatric patients on chronic hemodialysis: A cross-sectional study. 评论：儿童慢性血液透析患者的促红细胞生成素抵抗：一项横断面研究。

IF 2.6 3区医学

Pediatric Nephrology Pub Date : 2025-12-01 Epub Date: 2025-05-26 DOI: 10.1007/s00467-025-06835-w

Shree Rath

引用次数: 0

Liberation from pediatric continuous kidney replacement therapy: a survey of provider perceptions and practices. 从儿童持续肾脏替代治疗中解放出来：一项对提供者观念和实践的调查。

IF 2.6 3区医学

Pediatric Nephrology Pub Date : 2025-12-01 Epub Date: 2025-06-16 DOI: 10.1007/s00467-025-06849-4

Evan A Rajadhyaksha, Dana Y Fuhrman, Shina Menon, David T Selewski, Katja M Gist, Michelle C Starr

引用次数: 0

Effect of therapeutic plasma exchange on amoxicillin, clindamycin, midazolam, and morphine pharmacokinetics in a critically ill child. 治疗性血浆置换对危重患儿阿莫西林、克林霉素、咪达唑仑和吗啡药代动力学的影响。

IF 2.6 3区医学

Pediatric Nephrology Pub Date : 2025-12-01 Epub Date: 2025-07-03 DOI: 10.1007/s00467-025-06873-4

André Yaghyazaryan, Valentina Gracchi, Sybrand W J Zielhuis, Elisabeth H Schölvinck, Daan J Touw, Martin C J Kneyber, Paola Mian

引用次数: 0

Critical appraisal of "Renal perfusion in dynamic scans: a key predictor of long-term outcomes in posterior urethral valves". “动态扫描中的肾灌注：后尿道瓣膜长期预后的关键预测因素”的关键评价。

IF 2.6 3区医学

Pediatric Nephrology Pub Date : 2025-12-01 Epub Date: 2025-08-04 DOI: 10.1007/s00467-025-06928-6

Ahmad Shabbir, Fatima Shams, Muhammad Asim Agha

引用次数: 0

Renal perfusion in dynamic scans: a key predictor of long-term outcomes in posterior urethral valves. 动态扫描中的肾灌注：后尿道瓣膜长期预后的关键预测指标。

IF 2.6 3区医学

Pediatric Nephrology Pub Date : 2025-12-01 Epub Date: 2025-06-25 DOI: 10.1007/s00467-025-06858-3

Mamta Sengar, Ashvin Damdoo, Niyaz Khan, Chhabi Ranu Gupta, Parveen Kumar, Gaurav Jha, Sauradeep Dey

{"title":"Renal perfusion in dynamic scans: a key predictor of long-term outcomes in posterior urethral valves.","authors":"Mamta Sengar, Ashvin Damdoo, Niyaz Khan, Chhabi Ranu Gupta, Parveen Kumar, Gaurav Jha, Sauradeep Dey","doi":"10.1007/s00467-025-06858-3","DOIUrl":"10.1007/s00467-025-06858-3","url":null,"abstract":"Background: Nadir creatinine value is used as a key predictor of long-term kidney outcomes in patients with posterior urethral valves (PUV). This study explores the role of kidney perfusion status in dynamic renal scans as an additional predictor of future kidney outcome of these patients.Methodology: A prospective observational study was conducted over 2 years in a tertiary referral centre, involving patients above 2.5 years of age who followed a uniform bladder management protocol. Serial eGFR measurements were recorded and correlated with serum creatinine levels, nadir creatinine, episodes of urinary tract infection (UTI), and renal perfusion status as determined by renal dynamic scans.Results: Out of 112 patients, two-thirds presented during infancy. Mean age at first eGFR assessment was 6.17 ± 2.8 years. Creatinine at presentation and nadir creatinine varied significantly among the four perfusion groups (p = 0.003), with the highest creatinine levels observed in patients where the better-perfused kidney had poor perfusion. UTI episodes during follow-up were strongly associated with renal perfusion status (p = 0.003), with the highest incidence occurring in patients with impaired perfusion in their worse kidney. eGFR values also differed significantly across perfusion groups (p < 0.001). The eGFR at second follow-up (n = 81) was improved or static in patients with at least one renal unit well perfused while it declined progressively in patients with impaired perfusion of kidney units.Conclusion: This study highlights the value of renal dynamic scans in predicting renal reserve and long-term outcomes in patients with PUV. It also sheds light on the increased frequency of follow-up UTIs and the prolonged need for bladder management in specific patient subsets.","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3687-3695"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485371","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}

引用次数: 0

Alport syndrome complicated with steroid-sensitive nephrotic syndrome: a case report. Alport综合征合并类固醇敏感性肾病综合征1例。

IF 2.6 3区医学

Pediatric Nephrology Pub Date : 2025-12-01 Epub Date: 2025-06-24 DOI: 10.1007/s00467-025-06854-7

Qian Fu, Yuling Luo, Xingfeng Yao, Hui Wang

引用次数: 0