Metabolic syndrome-associated kidney disease in young adolescents and children.

The increasing prevalence of childhood obesity has led to a corresponding rise in metabolic syndrome (MetS), which is associated with a significant risk of kidney disease. There is a complex relationship between pediatric obesity and MetS, with metabolic derangements such as hypertension, dyslipidemia, and insulin resistance, contributing to kidney damage through multiple mechanisms. A focus on pediatric cardiovascular-kidney-metabolic health may lead to improvements in diagnosis, treatment, and management of MetS and kidney disease.

Pain and Analgesic Use in Patients With Chronic Kidney Disease Not on Dialysis: A Systematic Review.

Background: Chronic pain is common in patients with chronic kidney disease (CKD), yet pain management in non-dialysis-dependent CKD (NDD-CKD) is underexplored. Inappropriate analgesic use poses significant risks in this population.

Objective: To evaluate patterns of analgesic use-specifically opioids and NSAIDs-and associated clinical characteristics in patients with NDD-CKD.

Impact of Depression on Rehabilitation Outcomes in Pediatric Patients Undergoing ACL Reconstruction: A Retrospective Study.

Background: Depression in pediatric populations is rising rapidly and may adversely impact recovery from orthopaedic procedures such as anterior cruciate ligament (ACL) reconstruction. Although the psychological consequences of musculoskeletal injuries have been explored in adults, there remains a gap in understanding how depression affects postoperative outcomes in pediatric ACL patients.

Objective: This study aimed to evaluate whether depression is associated with differences in postoperative outcomes - including pain, physical function, medication use, and reoperation rates - among pediatric patients undergoing ACL reconstruction.

Liberation from continuous renal replacement therapy due to renal recovery in adults and children: a literature review and Delphi consensus on clinical practice.

Background: There is no current consensus on the appropriate timing for discontinuing continuous renal replacement therapy (CRRT). We aimed to review the current clinical evidence associated with the successful liberation from CRRT in patients with acute kidney injury and present a literature review with clinical practice points using a modified Delphi process.

Methods: EMBASE, CINAHL, PubMed, and CENTRAL libraries were searched for literature related to CRRT liberation in pediatric and adult AKI patients.

Oxidative Stress and Endothelial Dysfunction: The Pathogenesis of Pediatric Hypertension.

Pediatric hypertension is increasingly recognized as a complex condition shaped by both systemic and cellular factors, with oxidative stress emerging as a key driver of vascular dysfunction. In both their primary and secondary forms, reactive oxygen species (ROS) disrupt redox homeostasis, impair endothelial signaling, and promote inflammation and tissue remodeling. Metabolic dysregulation, renal pathology, and early-life stressors contribute to the accumulation of ROS through pathways involving NADPH oxidases, mitochondrial dysfunction, xanthine oxidase activity, and altered arginine metabolism.

Updated Gene Therapy for Renal Inborn Errors of Metabolism.

Inborn errors of metabolism (IEMs) are a group of disorders resulting from defects in enzymes in metabolic pathways. These disorders impact the processing of metabolites, leading to a wide array of effects on each organ system. Advances in genetic screening have allowed for the early identification and intervention of IEMs, traditionally in the form of enzyme replacement or vitamin supplementation.

Educational Gaps and Suggestions for Change for Pediatric Transplant Fellowship Training Based on Fellow Survey Responses.

Background: Advancements in organ transplant technology are pushing global transplant capabilities to new heights. However, challenges persist in pediatric surgical and medical transplant fellowship training, primarily due to a limited number of adequate training programs and gaps in education. Addressing these gaps is essential for improving patient outcomes and advancing the field of pediatric transplantation.

Pediatric kidney replacement therapies in low-to-middle income countries: a review and white paper.

Acute kidney injury (AKI) disproportionately impacts children in low- and middle-income countries (LMICs), where up to 85% of AKI cases occur. As for pediatric chronic kidney disease (CKD), the true burden in LMICs remains unclear, as many cases go undiagnosed early, and other children succumb without adequate treatment. Unfortunately, these disparities result from limited access to kidney replacement therapy (KRT), kidney laboratory and imaging resources, healthcare provider shortages, and financial barriers.

Predictive Factors for the Discontinuation of Renal Replacement Therapy in Critically Ill Adults: A Systematic Review and Meta-Analysis.

Acute kidney injury (AKI) is a decline in kidney function. Acute kidney injury frequently occurs as a complication among patients who are hospitalized or critically ill. Consequently, we aimed to examine the factors that could predict the cessation of renal replacement therapy (RRT) in individuals with severe AKI.

Transitioning from pediatric- to adult-focused dialysis care: A systematic review with recommendations.

Background: There is limited data evaluating the practices of nephrologists who prepare dialysis-dependent adolescents and young adults (AYA) for healthcare transition (HCT) from pediatric- to adult-focused healthcare. The aims of this manuscript are 1) critically evaluate the current evidence and experiences surrounding HCT from pediatric- to adult-focused dialysis units, 2) make recommendations that can be implemented for this process.

Materials And Methods: We searched PubMed, EMBASE, CINAHL, COCHRANE, and clinicaltrials.

Diluted Regional Citrate Anticoagulation for Continuous Renal Replacement Therapy in Pediatric Patients: A Systematic Review and Suggested Practice Points.

Introduction: Continuous renal replacement therapy (CRRT) is increasingly used in critical pediatric patients with acute kidney injury (AKI). The choice of anticoagulant is vital to minimize circuit clotting and bleeding complications. Regional citrate anticoagulation (RCA) is preferred for its safety profile, particularly in critically ill pediatric patients who are susceptible to bleeding.

CRB2 depletion induces YAP signaling and disrupts mechanosensing in podocytes.

Focal segmental glomerulosclerosis (FSGS) is a histologic lesion caused by a variety of injurious stimuli that lead to dysfunction/loss of glomerular visceral epithelial cells (i.e., podocytes).

Artificial intelligence and pediatric acute kidney injury: a mini-review and white paper.

Acute kidney injury (AKI) in pediatric and neonatal populations poses significant diagnostic and management challenges, with delayed detection contributing to long-term complications such as hypertension and chronic kidney disease. Recent advancements in artificial intelligence (AI) offer new avenues for early detection, risk stratification, and personalized care. This paper explores the application of AI models, including supervised and unsupervised machine learning, in predicting AKI, improving clinical decision-making, and identifying subphenotypes that respond differently to interventions.

Low Density Lipoprotein Apheresis for Treatment of Focal Segmental Glomerulosclerosis.

Focal segmental glomerulosclerosis (FSGS) has become one the leading causes of kidney disease in the United States. With the incidence of FSGS rising over the past decade, capable treatment options have been a large focus in research. One therapy that shows promise is low density lipoprotein apheresis (LDL-A).

Perceptions and Earliest Experiences of Medical Students and Faculty With ChatGPT in Medical Education: Qualitative Study.

Background: With the rapid development of artificial intelligence technologies, there is a growing interest in the potential use of artificial intelligence-based tools like ChatGPT in medical education. However, there is limited research on the initial perceptions and experiences of faculty and students with ChatGPT, particularly in Saudi Arabia.

Objective: This study aimed to explore the earliest knowledge, perceived benefits, concerns, and limitations of using ChatGPT in medical education among faculty and students at a leading Saudi Arabian university.

Disaster preparedness and kidney health in children.

Disasters pose significant risks to vulnerable populations, particularly children with chronic health conditions such as kidney disease. This paper explores the unique challenges faced by children with kidney disease during and after disasters, focusing on disruptions to essential medical services such as dialysis, access to clean water, and maintenance medications. The vulnerability of these children is further amplified in low-resource settings, where disaster preparedness is often lacking.

Decoding Monogenic Hypertension: A Review of Rare Hypertension Disorders.

Background: Hypertension is a growing concern worldwide, with increasing prevalence rates in both children and adults. Most cases of hypertension are multifactorial, with various genetic, environmental, socioeconomic, and lifestyle influences. However, monogenic hypertension, a blanket term for a group of rare hypertensive disorders, is caused by single-gene mutations that are typically inherited in an autosomal dominant fashion, and ultimately disrupt normal blood pressure regulation in the kidney or adrenal gland.

IPNA clinical practice recommendations on care of pediatric patients with pre-existing kidney disease during seasonal outbreak of COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic, instigated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has profoundly impacted healthcare infrastructures around the globe. While children are usually asymptomatic or have mild symptoms, children with pre-existing kidney conditions require specialized attention. This pivotal report, championed by the International Pediatric Nephrology Association (IPNA), delivers precise and actionable recommendations tailored for pediatric patients with kidney ailments in this pandemic landscape.

Extrarenal manifestations of atypical hemolytic uremic syndrome: a systematic review and meta-analysis.

Background: Atypical Hemolytic Uremic Syndrome (aHUS) is categorized as a thrombotic microangiopathy (TMA), which arises due to abnormal or unregulated complement pathway activation. While the disease frequently affects renal blood vessels, it can also involve multiple other organ systems. This review examines the prevalence and clinical outcomes of aHUS patients with extrarenal involvement.