Pediatric Nephrology最新文献

{"title":"Long-term kidney side effects of allogeneic hematopoietic stem cell transplantation in children.","authors":"Dilek Kaçar, Sare Gülfem Özlü, Özlem Arman Bilir, İkbal Ok Bozkaya, Şerife Mehtap Kanbur, Ayça Koca Yozgat, Özlem Yüksel Aksoy, Umut Selda Bayrakçı, Namık Yaşar Özbek","doi":"10.1007/s00467-025-06921-z","DOIUrl":"10.1007/s00467-025-06921-z","url":null,"abstract":"<p><strong>Background: </strong>Hematopoietic stem cell transplantation (HSCT) is an effective treatment for various childhood diseases with long-term complications, including kidney side effects.</p><p><strong>Methods: </strong>We conducted a single-center retrospective study of 213 patients who received allogeneic HSCT between February 2011 and December 2023. Patients were followed for at least 3 months post-HSCT, with a median follow-up of 2.9 years. We evaluated pre- and post-HSCT estimated glomerular filtration rate (eGFR) and kidney complications.</p><p><strong>Results: </strong>After HSCT, patients showed significantly higher rates of acute kidney injury (21.6% vs. 4.1% pre-HSCT), hypertension (26.8% vs. 5.2% pre-HSCT), and tubulopathy (20.2% vs. 5.2% pre-HSCT). The median final eGFR was 144 mL/min/1.73 m², which was significantly lower than the pre-HSCT eGFR (155 mL/min/1.73 m², p < 0.0001) and negatively correlated with time after HSCT (Rs =  - 0.177, p = 0.009). Eight patients (3.8%) progressed to chronic kidney disease (CKD). Factors linked to CKD included inherited bone marrow failure syndromes, anti-thymocyte globulin (ATG) conditioning, urinary tract infections (UTIs), and high urinary BK virus loads. Although the rates of glomerular hyperfiltration (GHF) did not change significantly between pre-HSCT (63.8%) and post-HSCT (62.4%, p = 0.824), GHF was notable in patients with acute lymphoblastic leukemia pre-HSCT and thalassemia post-HSCT. Seventeen patients (8.4%) needed ongoing antihypertensive treatment.</p><p><strong>Conclusions: </strong>HSCT can cause various kidney complications. GHF is common both before and after transplant, and eGFR often declines over time. UTIs, ATG conditioning, and inherited bone marrow failure syndromes are important risk factors for CKD. Individual factors and infection surveillance should be considered in these patients to approach kidney health.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3775-3783"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799795","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":"Anti-CD20 monoclonal antibodies for idiopathic nephrotic syndrome: Advances, challenges, and future directions.","authors":"Andrea Angeletti, Gian Marco Ghiggeri","doi":"10.1007/s00467-025-06738-w","DOIUrl":"10.1007/s00467-025-06738-w","url":null,"abstract":"","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3597-3600"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992159","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":"Critical insights on post-infectious glomerulonephritis among children before and during the COVID-19 pandemic.","authors":"Sadeeq Khan, Abdur Rehman, Waheed Khan","doi":"10.1007/s00467-025-06886-z","DOIUrl":"10.1007/s00467-025-06886-z","url":null,"abstract":"","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3591"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529202","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":"Evidence-based risk stratification for neonatal acute kidney injury: a call to action.","authors":"Tahagod Mohamed, Nicole Asdell, Xia Ning, Jason G Newland, Matthew W Harer, Cara L Slagle, Michelle C Starr, John D Spencer, Francis P Wilson, David T Selewski, Jonathan L Slaughter","doi":"10.1007/s00467-025-06752-y","DOIUrl":"10.1007/s00467-025-06752-y","url":null,"abstract":"","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3335-3339"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720452","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":"Effect of losartan on uric acid metabolism in children with proteinuric kidney disease: crossover randomized controlled clinical trial.","authors":"Laura Beaudoin, Luciana Meni Battaglia, Sandra Mariel Martin, Ismael Toledo, Alejandro Balestracci","doi":"10.1007/s00467-025-06754-w","DOIUrl":"10.1007/s00467-025-06754-w","url":null,"abstract":"<p><strong>Background: </strong>Low uric acid (UA) levels are desirable in kidney disease. Enalapril is the most used reno-protective drug; losartan has a similar antihypertensive and antiproteinuric effect, but also induces hyperuricosuria due to tubular urate transporter 1 inhibition. As this effect has not been demonstrated in paediatrics, we assessed if losartan reduces serum UA in children, owing to an increase in its urinary excretion, compared to enalapril.</p><p><strong>Methods: </strong>Single-centre, open-label, crossover randomized trial. Patients aged 3-12 years with proteinuric kidney disease and estimated glomerular filtration rate ≥ 30 ml/min/1.73 m², were assigned to receive enalapril or losartan for 30 days. Then, all patients received 15-days of enalapril to washout the effect of losartan in those who received it. Subsequently, they were switched to the opposite treatment modality.</p><p><strong>Results: </strong>Forty patients were included (36 CKD stage 1, 4 stage 2), median age 8.58 years; median serum UA 4 mg/dL (IQR, 3.5-5.1). Losartan significantly increased median UA urinary fractional excretion from 7% (IQR 6-8.27) to 8.9% (IQR 6.3-11) (p < 0.001) and significantly reduced its median serum level from 4.2 mg/dL (IQR 3.4-4.9) to 3.6 mg/dL (IQR 2.9-4.5) (p < 0.001). Median urinary excretion [pre 6.65% (IQR 5-8.41) vs. post 7% (IQR 5.5-8.3), p = 0.61)] and median serum values [pre 4.2 mg/dL (IQR 3.6-5.1) vs. post 4.1 mg/dL (IQR 3.4-5), p = 0.42)] were comparable with enalapril. The decrease in serum UA levels post-losartan correlated with the increase in its urinary excretion (r = -0.33; p = 0.036).</p><p><strong>Conclusions: </strong>Losartan significantly increased UA urinary excretion along with the consequent reduction in its serum levels.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3495-3503"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507323","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":"In vitro measurements of ultrafiltration precision in hemofiltration and hemodialysis devices used in infants, Part 2: Comparison of PrisMax and CARPEDIEM with previous data on NIDUS, Prismaflex and Aquarius.","authors":"Jean Crosier, Denise Colosimo, Rachel Hansen, Heather J Lambert, Malcolm G Coulthard, Zaccaria Ricci","doi":"10.1007/s00467-025-06788-0","DOIUrl":"10.1007/s00467-025-06788-0","url":null,"abstract":"<p><strong>Background: </strong>We sought to determine in vitro whether the PrisMax and CARPEDIEM hemofiltration and hemodialysis devices can reliably deliver ultrafiltration (UF) control that is sufficiently precise to treat infants.</p><p><strong>Methods: </strong>We have previously measured the precision of UF control of the Prismaflex, Aquarius and NIDUS devices by in vitro testing with a bag of saline set up as a dummy patient, and comparing the differences between the UF set and displayed by the devices, and the actual fluid removal or addition measured by precise weighing. Here we have tested the PrisMax (updated version of Prismaflex) and the CARPEDIEM using the same method.</p><p><strong>Results: </strong>The variances of the setting vs. actual errors, and display vs. actual errors after 15 min of 'treatment' with the PrisMax and CARPEDIEM were similar, but were significantly larger than in the NIDUS, and much smaller than in the Prismaflex. However, after a 4-h 'treatment session', the cumulative errors were still within ± 9 mL for these devices, compared with a maximum error of 2.6 mL in the NIDUS, and a deviation of -37.5 mL in the Prismaflex.</p><p><strong>Conclusions: </strong>The PrisMax and the CARPEDIEM have adequate precision to be used in infants. The only device with UF error below 3 ml in 4 h is the volumetrically-controlled NIDUS. We recommend that regulatory bodies should introduce UF precision-testing for devices intended for use in infants.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3549-3554"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584490","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":"Urinary DKK3 in Alport syndrome: early marker or epiphenomenon?","authors":"Iqra Nasir, Fida Hussain, Muhammad Ibrahim","doi":"10.1007/s00467-025-06879-y","DOIUrl":"10.1007/s00467-025-06879-y","url":null,"abstract":"","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3589"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507324","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":"IPNA webinars: an effective teaching platform advancing patient care in pediatric nephrology worldwide.","authors":"Eugene Yu-Hin Chan, Sharon Teo, Michelle López, Abdullahi Mudi, Pankaj Hari, Olivia Boyer, John D Mahan, Dieter Haffner, Elena Levtchenko","doi":"10.1007/s00467-025-06775-5","DOIUrl":"10.1007/s00467-025-06775-5","url":null,"abstract":"","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3341-3345"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047432","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 better outcomes in pediatric septic shock: the role of practical risk models.","authors":"Ziwei Zhao, Hujie Dong, Huihua Zhu","doi":"10.1007/s00467-025-06907-x","DOIUrl":"10.1007/s00467-025-06907-x","url":null,"abstract":"","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3593-3594"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855952","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":"Epidemiology and outcome of pediatric acute kidney injury-multicenter observational study from a low-middle-income country.","authors":"Uma Ali, Amol Madave, Kinnari Vala, Sadhana Zope, Manoj Matnani, Jyoti Singhal, Anupama Mauskar, Poonam Wade, Radha Ghildiyal, Jyoti Sharma, Madhulika Chakravarthi, Puneet Chhajed, Nivedita Pande, Nisha Krishnamurthy, Aarthi Prasanna, Kiran Sathe, Atul Deokar, Manish Arya, Vaibhav Keskar, Pawan Deore","doi":"10.1007/s00467-025-06856-5","DOIUrl":"10.1007/s00467-025-06856-5","url":null,"abstract":"<p><strong>Background: </strong>The epidemiology and outcome of acute kidney injury (AKI) in low-middle-income countries (LMICs) differ from those in high-income countries due to differences in type and severity of non-renal systemic illness and variability in nephrology-care facilities. There is a paucity of multicenter studies from LMICs. This multicenter observational study was undertaken to study the epidemiology of pediatric AKI in a LMIC and analyze the significance of associated sample characteristics and interventions on outcomes, namely renal recovery and mortality.</p><p><strong>Methods: </strong>Children (1 month-18 years) diagnosed with AKI, based on KDIGO criteria, seen in 10 centers, over 30 months, were included. Data collected included hospital type, city, patient demographics, illness characteristics, pre-existing diseases, AKI profile, interventions including mechanical ventilation (MV), vasoactive drugs (VADs), nephrotoxic drugs, radiocontrast exposure, and recent surgery. Use of kidney replacement therapy (KRT), modality, renal recovery, and patient survival was assessed.</p><p><strong>Results: </strong>Non-renal systemic illness accounted for 79% of cases. Majority were infections. Pre-existing illness was present in 55%, with 29% having kidney disease. AKI was diagnosed at admission in 68%, with 40% in KDIGO stage 3; 50% had severe AKI. MV and VADs were used in 42% and 46%, respectively. KRT was required in 29%, most receiving acute peritoneal dialysis (58%). Complete recovery (CR) was seen in 44%, while 29.6% died. Pre-existing kidney disease and KRT negatively impacted CR. VAD use was linked to mortality, and CR was associated with survival.</p><p><strong>Conclusions: </strong>Non-renal systemic infection was the leading cause of AKI characterized by early, rapid progression, severe in 50%, high need for KRT, CR in less than 50% and high mortality.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"3539-3547"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541800","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}