Pediatric nephrology (Berlin, Germany)
Audio Summaries

IPNA clinical practice recommendations for the management of aHUS and secondary TMA in children

Sep 23, 2026

The authors aim to establish Clinical Practice Recommendations (CPRs) and Practice Points (CPPs) for the diagnosis and management of atypical hemolytic uremic syndrome (aHUS) and secondary thrombotic microangiopathies (TMAs) in children, based on expert consensus and current evidence. They formulated six structured clinical questions to guide their recommendations, resulting in 51 CPRs and 9 CPPs that address various forms of aHUS and secondary TMA, while considering the unique challenges faced in less resourced countries. Ultimately, the goal is to standardize care and improve patient outcomes globally.

Is there an interaction between hypertension and proteinuria in pediatric chronic kidney disease progression? Evidence from the SP-CKD-Kids cohort

Sep 22, 2026

The authors aimed to investigate whether hypertension and proteinuria interact multiplicatively to influence the progression of chronic kidney disease (CKD) in a pediatric population. In their study of 254 children with CKD stages 3-4, they found that both hypertension and proteinuria were independent risk factors for CKD progression, with the highest risk observed in patients with both conditions. However, the analysis did not reveal a statistically significant interaction between hypertension and proteinuria, suggesting that while both factors are important, their combined effect may not be as straightforward as previously thought.

Developmental defects of enamel in children with nephrotic syndrome: a cross-sectional study of proportion and independently associated factors

Sep 22, 2026

This study aimed to investigate the prevalence, distribution, and severity of developmental defects of enamel (DDE) in children with nephrotic syndrome (NS) and identify associated factors. The findings revealed that 33.8% of children had DDE, predominantly affecting permanent teeth, with permanent dentition being an independent correlate of DDE. The authors suggest the need for interdisciplinary collaboration between pediatric nephrology and stomatology, as the relationship between steroid-dependent NS and DDE warrants further investigation.

Left ventricular remodeling by cardiac magnetic resonance in children with advanced chronic kidney disease: an analysis of the Chronic Kidney Disease in Children (CKiD) study

Sep 21, 2026

The authors aimed to investigate the relationship between advanced chronic kidney disease (CKD) and cardiovascular disease severity in children by analyzing cardiac magnetic resonance (CMR) features in a subset of participants from the Chronic Kidney Disease in Children (CKiD) study. They found that left ventricular hypertrophy (LVH) was prevalent in 13% of the cohort, and abnormal myocardial strain was common, with 60% and 68% of participants exceeding normative thresholds for global peak longitudinal strain (GLS) and circumferential strain (GCS), respectively. The study concluded that higher left ventricular mass index was associated with lower GLS and GCS, indicating significant cardiovascular implications in children with advanced CKD.

Acute kidney injury in neonates with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia: impact of diagnostic criteria and clinical predictors

Sep 16, 2026

This study investigates the incidence, clinical predictors, and diagnostic agreement of acute kidney injury (AKI) in neonates with hypoxic-ischemic encephalopathy (HIE) treated with therapeutic hypothermia. The authors found that AKI occurred in 47% of cases using the nKDIGO criteria and 33% using the Gupta criteria, with weak agreement between the two classifications. The findings highlight the variability in AKI definitions and the importance of early renal monitoring in this vulnerable population.

The incidence and risk factors associated with severe acute kidney injury and operative mortality in neonates following cardiac surgery: a single-center experience

Sep 16, 2026

The authors aimed to investigate the incidence and risk factors for severe acute kidney injury (AKI) and operative mortality in neonates undergoing cardiac surgery, particularly comparing those with single ventricle physiology to those with biventricular physiology. Their study found a high prevalence of severe postoperative AKI (approximately 50%) and an operative mortality rate of 8% overall, with longer cardiopulmonary bypass time and delayed sternal closure identified as significant risk factors. The findings highlight the need for further research to develop predictive tools for AKI in this vulnerable population.

Rare forms of autosomal dominant tubulointerstitial kidney disease in children: a retrospective case series from Oman

Sep 12, 2026

This study aims to characterize rare forms of autosomal dominant tubulointerstitial kidney disease (ADTKD) in children, particularly in the context of limited genetic testing access in Oman. The authors report on five pediatric patients with genetically confirmed rare ADTKD variants, expanding the known clinical features associated with these conditions, including the identification of hypomagnesemia in REN-related disease and the novel association of epilepsy with SEC61A1-related ADTKD. The findings emphasize the critical need for early genetic testing to improve diagnosis and management in affected children.

Neonatal acute kidney injury and the patent ductus arteriosus

Sep 10, 2026

The authors investigate the relationship between patent ductus arteriosus (PDA) and neonatal acute kidney injury (AKI) in premature infants, questioning how ductal patency and its management may influence kidney health. They highlight that while PDA is linked to systemic hypoperfusion and may exacerbate AKI, current therapeutic interventions can also pose risks to renal function. The review aims to clarify the physiological implications of PDA in the context of neonatal AKI and the factors contributing to kidney injury in this vulnerable population.

Adequacy of dialysis in children and adolescents: more than just Kt/V

Sep 10, 2026

The authors investigate the evolving concept of dialysis adequacy in children and adolescents, questioning whether traditional measures like urea clearance (Kt/V) are sufficient. They highlight the importance of considering the removal of middle molecules, phosphorus control, and personalized treatment approaches that incorporate patient and family perspectives to improve clinical outcomes and quality of life. The study advocates for a more comprehensive and individualized approach to dialysis adequacy beyond conventional metrics.

Adjunctive metolazone in critically ill children with moderate-to-severe acute kidney injury and furosemide-refractory fluid overload

Sep 10, 2026

The authors aimed to evaluate the efficacy of metolazone in critically ill children with moderate-to-severe acute kidney injury (AKI) who were experiencing fluid overload and were unresponsive to furosemide. The study found that metolazone treatment significantly increased urine output, and a greater increase in urine output within the first 24 hours was associated with a reduced likelihood of requiring kidney replacement therapy (KRT). These findings suggest that metolazone may be beneficial in this patient population, but further prospective studies are needed to validate the results.