Pediatric anesthesia & critical care
Kidney Replacement Therapies and Outcomes in Children With Crush Syndrome–Associated Kidney Injury
Main finding · Dialysis dependency at dischargeResult — go to the resultOdds ratio 2.18 95% CI 0.53–8.98Authors' conclusion
This cohort study found that children who were transferred late to intensive care and those with a high trauma score after earthquake-related crush injury were more likely to remain dialysis-dependent at discharge. Furthermore, KDIGO stage at admission was associated with elevated serum creatinine phosphokinase levels.
Study context
- Population
- Children with crush syndrome after the 2023 Kahramanmaraş earthquake, Turkey90 required kidney replacement therapy (KRT)
- Participants
- 183 children
- Exposure
- KRT modalities
- Intermittent hemodialysis (IHD)n = 23
- Continuous venovenous hemodiafiltrationn = 33
- Outcome
- Dialysis dependency
- Follow-up
- Discharge
Methodological detailsmulticentre, 20 pediatric intensive care unit (PICUs)
- Multicentre
- 20 PICUs
Main finding
Dialysis dependency at discharge
Odds ratio
2.18
95% CI 0.53–8.98
P = 0.28
As reported in the abstract
- Late transfer to PICU associated with higher dialysis dependency
- 0.003 (β; 95% CI 0.001-0.005; P < .001)
- High Pediatric Trauma Score associated with higher dialysis dependency
- 0.022 (β; 95% CI 0.003-0.041; P = 02)
Observational data: associations, not effects.
Secondary outcomes
Shorter PICU length of stay (LOS)
| OR (95% CI) | P value | ||
|---|---|---|---|
| IHDOnly independent factor | 6.87 (1.54–30.67) | P = 0.01 | |
| 0.050.21520Odds ratio (log scale) |
Kidney Disease-Improving Global Outcomes (KDIGO) stage at admission vs serum creatinine phosphokinase
- AUC
- 0.750 (95% CI 0.621-0.879; P < .001)
Overall mortality
- Deaths in the cohort, 6 patients
- 6.6%
Original publication
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