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Is the renal score predictive for kidney replacement therapy in pediatric patients with crush syndrome?

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Abstract

Background

Crush syndrome (CS) is a systemic condition resulting from rhabdomyolysis caused by prolonged pressure on muscle tissue. It is estimated that CS will develop in approximately 2–5% of all injuries related to an earthquake, and acute kidney injury (AKI) will develop in approximately 1.5% of all injuries. The present study aimed to present the evaluation of pediatric patients with CS who developed AKI to determine the risk factors that can be determined beforehand for the need for dialysis and to present a new scoring developed for dialysis indication.

Methods

Pediatric patients with CS and who underwent dialysis for AKI were included in the study. The study was conducted retrospectively and as single-center data. A renal scoring system that determines the indications for dialysis in patients with CS by parameters of eGFR, creatine phosphokinase (CPK), time under rubble, presence of amputation or fasciotomy, and urine volume was included.

Results

The mean age was 11.53 ± 4.50 years, and 58.4% of the group were male. Among the 77 patients, 33 (42.8%) underwent kidney replacement therapy (KRT). Renal score, CPK level, and presence of myoglobinuria were determined to be the best markers for KRT indication in pediatric patients with CS (p < 0.01, p = 0.02, and p < 0.01, respectively).

Conclusions

We suggest that if a similar disaster occurs in the future, an easy and applicable renal scoring system can contribute to the prognosis by providing appropriate and early treatment for KRT.

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Acknowledgements

The authors gratefully acknowledge Mr. Scribendi editing service for English language editing.

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Authors and Affiliations

  1. Department of Pediatric Nephrology, Ankara Etlik City Hospital, Ankara, Turkey

    Deniz Karakaya, Aysun Çaltık Yılmaz, Tülin Güngör, Bahriye Uzun Kenan, Evra Çelikkaya & Evrim Kargın Çakıcı

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  1. Deniz Karakaya
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  2. Aysun Çaltık Yılmaz
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  3. Tülin Güngör
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  6. Evrim Kargın Çakıcı
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Contributions

Study concept and design: Deniz Karakaya, Aysun Çaltık Yılmaz.

Analysis and interpretation of data: Deniz Karakaya, Tülin Güngör, Bahriye Uzun Kenan, Evrim Kargın Çakıcı.

Drafting of the manuscript: Deniz Karakaya, Tülin Güngör, Evra Çelikkaya,

Critical revision of the manuscript for important intellectual content: Deniz Karakaya, Evrim Kargın Çakıcı.

Corresponding author

Correspondence to Evrim Kargın Çakıcı.

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We confirm that this work is original and has not been published elsewhere, nor is it currently under consideration for publication elsewhere. All authors accept the copyright of the journal.

Ethics approval

The study protocol was approved by the Ankara Etlik City Hospital Ethics Committee.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Karakaya, D., Yılmaz, A.Ç., Güngör, T. et al. Is the renal score predictive for kidney replacement therapy in pediatric patients with crush syndrome?. Pediatr Nephrol 39, 291–296 (2024). https://doi.org/10.1007/s00467-023-06090-x

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  • DOI: https://doi.org/10.1007/s00467-023-06090-x

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