Assessment of Protein Energy Wasting in Children With Chronic Kidney Disease: A Cross-Sectional Study.

Objectives: Limited studies exist on prevalence of Protein energy wasting (PEW) in children with chronic kidney disease. The study aimed to determine the prevalence of PEW in children aged 2-18 years with CKD stage 2-5D, compare various diagnostic criteria and describe clinical characteristics of children with PEW.

Methods: A cross-sectional study (September 2023 to February 2024) conducted at the pediatric nephrology services of a tertiary-care center investigated children aged 2-18 years diagnosed with CKD stages 2-5D for PEW.

Outcomes of acute peritoneal dialysis using rigid catheters in the critically ill pediatric population.

BackgroundPeritoneal dialysis (PD) offers comparable survival for acute kidney injury (AKI) as other kidney replacement therapies, but concerns about rigid catheter complications like peritonitis persist. This study evaluated outcomes of acute PD using rigid catheters in critically ill children, including peritonitis rates and mechanical complications.MethodsThis retrospective study analyzed data from consecutive pediatric patients (aged <18 years) admitted to our tertiary-level pediatric intensive care unit, who underwent acute PD using either rigid or improvised catheters, with each PD session limited to 72 h followed by re-insertion after 24 h if indicated.

Clinical Characteristics and Outcomes of Children with Unilateral Multicystic Dysplastic Kidney: A Cohort Study.

Objectives: To study the clinical profile and outcomes of children with unilateral multicystic dysplastic kidney (MCDK).

Methods: We assessed the clinical features and extrarenal manifestations in children with unilateral MCDK. These children were followed up to ascertain involution, compensatory hypertrophy and progression of chronic kidney disease (CKD) stage.

Clinical characteristics, disease flares, infections and their impact on kidney outcomes in pediatric lupus nephritis: A cohort study.

Background: Limited data exists on clinical predictors of kidney outcomes in children with lupus nephritis (LN).

Methods: Children aged below 18 years with biopsy-proven LN followed from January 2010 to February 2024 in a tertiary-care center were enrolled in order to characterize their clinical presentations, flares, infections, histology and determine Major Adverse Kidney Events (MAKE) (defined as eGFR < 60 mL/min/1.73 m and/or death).

Experience of continuous kidney replacement therapy in a tertiary care unit of a lower-middle-income country.

Background: Information on the clinical characteristics and outcomes of children undergoing continuous kidney replacement therapy (CKRT) from lower-middle-income countries (LMIC) is limited.

Methods: Records of consecutive children 1 month to 18 years of age who underwent CKRT from Jan 2016 to Jan 2024 in a tertiary care pediatric intensive care unit (PICU) were retrospectively reviewed and analyzed for clinical and machine-related characteristics, and outcomes.

Results: Over the 8-year period, 102 patients (61.

Etiology, clinical characteristics, genetic profile, and outcomes of children with refractory rickets at a referral center in India: a cohort study.

Background: Limited research exists regarding the genetic profile, clinical characteristics, and outcomes of refractory rickets in children from India.

Methods: Patients with refractory rickets aged ≤ 18 years were enrolled. Data regarding clinical features, etiology, genotype-phenotype correlation, and estimated glomerular filtration rate (eGFR) were recorded.

Furosemide stress test to predict acute kidney injury progression in critically ill children.

Background: Furosemide stress test (FST) is a novel functional biomarker for predicting severe acute kidney injury (AKI); however, pediatric studies are limited.

Methods: Children 3 months to 18 years of age admitted to the intensive care unit (ICU) of a tertiary care hospital from Nov 2019 to July 2021 were screened and those who developed AKI stage 1 or 2 within 7 days of admission underwent FST (intravenous furosemide 1 mg/kg). Urine output was measured hourly for the next 6 h; a value > 2 ml/kg within the first 2 h was deemed furosemide responsive.

Kidney outcomes in children with primary focal segmental glomerulosclerosis from a low- and middle- income country.

Background: Limited data exists regarding the clinical course and outcomes of children with primary focal segmental glomerulosclerosis (FSGS) from low- and middle- income countries.

Methods: Children aged 1-18 years with biopsy-proven primary FSGS followed from January 2010-June 2023 in a tertiary-care center were enrolled and their clinical profile, histological characteristics, kidney outcomes, and predictors of adverse outcomes were determined.

Results: Over 13 years, 73 (54.

Congenital nephrotic syndrome with diffuse mesangial sclerosis caused by compound heterozygous mutation in LAMA5 gene.

A two-and-a-half-month-old female infant presented with generalized edema for 10 days. At presentation, she had periorbital puffiness, moderate ascites, and pedal edema. Laboratory investigations revealed serum albumin 1.

Intravenous cyclophosphamide therapy in children with calcineurin inhibitor-resistant steroid-resistant nephrotic syndrome in a resource-limited setting.

Background: In pediatric steroid-resistant nephrotic syndrome (SRNS), calcineurin inhibitors (CNIs) are recommended as first-line therapy, with efficacy ranging between 60 and 80%, implying a substantial proportion will exhibit CNI resistance. Which alternate immunosuppressive therapy should be used in non-genetic pediatric SRNS exhibiting CNI resistance is especially relevant in low- to middle-income countries (LMIC), where the prohibitive costs of certain drugs such as monoclonal antibodies often determine therapy choice.

Methods: The primary objective was to assess the efficacy of intravenous cyclophosphamide in a proportion of children aged 1-18 years with CNI-resistant SRNS with a complete response (CR) or partial response (PR) at 6 months from commencement of pulse therapy.

Etiology and Outcomes of Rapidly Progressive Glomerulonephritis in Children: A Retrospective Cohort Study.

Objective: To study the clinico-etiological spectrum and outcomes of children with rapidly progressive glomerulonephritis (RPGN).

Methods: This retrospective cohort study evaluated patients <18 years with RPGN, over an 8-year period (2014-2022), for etiology and kidney outcomes.

Results: Among 68 RPGN cases [median age 10 (7,12) years], 23 (33.

Growth Parameters in Adolescents With Idiopathic Nephrotic Syndrome Diagnosed at the Age of 1-6 Years.

Objective: To determine the prevalence of impaired growth parameters (height and BMI z scores) among adolescents aged 10-19 years, with onset of idiopathic nephrotic syndrome between the age of 1 and 6 years.

Methods: A cross-sectional study was conducted among adolescents aged 10-19 years with onset of idiopathic nephrotic syndrome between the age of 1-6 years, and under regular follow-up at our center. The data were retrieved for a 10-year period (2012-2022).

Distal renal tubular acidosis as presenting manifestation of Wilson disease in a 11-year-old girl.

A 11-year-old girl was referred to the pediatric nephrology services of our hospital for evaluation of vitamin-D-refractory rickets. She was born to second-degree consanguineous parents. On examination, she had wrist widening and bilateral genu varum.

Etiology and outcomes of acute kidney disease in children: a cohort study.

Background: There is paucity of information regarding the etiology and outcomes of Acute Kidney Disease (AKD) in children.

Methods: The objectives of this cohort study were to evaluate the etiology and outcomes of AKD; and analyze predictors of kidney survival (defined as free of CKD 2, 3a, 3b, 4 or 5). Patients aged 1 month to 18 years who developed AKD over a 4-year-period (January 2018-December 2021) were enrolled.

Management of Acute Kidney Injury in Critically Ill Children.

Acute kidney injury (AKI) is common in critically ill patients, affecting almost one in four critically ill children and one in three neonates. Higher stages of AKI portend worse outcomes. Identifying AKI timely and instituting appropriate measures to prevent and manage severe AKI is important, since it is independently associated with mortality.