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. 2024 Jul;39(7):2209-2215.
doi: 10.1007/s00467-024-06307-7. Epub 2024 Feb 15.

The 2023 Türkiye-Syria earthquakes: analysis of pediatric victims with crush syndrome and acute kidney Injury

Serra Sürmeli Döven  1 , Özlem Tezol  2 , Edanur Yeşil  3 , Fatma Durak  2 , Merve Mısırlıoğlu  4 , Mehmet Alakaya  4 , Feryal Karahan  5 , İsa Kıllı  6 , Mehtap Akça  3 , Semra Erdoğan  7 , Mevlüt Can  8 , Ali Delibaş  8
Affiliations

The 2023 Türkiye-Syria earthquakes: analysis of pediatric victims with crush syndrome and acute kidney Injury

Serra Sürmeli Döven et al. Pediatr Nephrol. 2024 Jul.

Abstract

Background: On February 6th, 2023, two consecutive earthquakes struck southeastern Türkiye with magnitudes of 7.7 and 7.6, respectively. This study aimed to analyze the clinical and laboratory findings, as well as management of pediatric victims with Crush Syndrome (CS) and Acute Kidney Injury (AKI).

Methods: The study included pediatric earthquake victims who were presented to Mersin University Hospital. Clinical and laboratory characteristics of the patients were collected retrospectively.

Results: Among 649 patients, Crush injury (CI), CS and AKI was observed in 157, 59, and 17 patients, respectively. White blood cell count (12,870 [IQR: 9910-18700] vs. 10,545 [IQR: 8355-14057] /µL, P < 0.001), C-reactive protein (51.27 [IQR: 14.80-88.78] vs. 4.59 [1.04-18.25] mg/L, P < 0.001) and myoglobin levels (443.00 [IQR: 198.5-1759.35] vs. 17 [11.8-30.43] ng/ml) were higher in patients with CS, while their sodium (IQR: 134 [131-137] vs. 136 [134-138] mEq/L, P < 0.001) levels were lower compared to non-CS patients. An increase in myoglobin levels was identified as an independent risk factor for developing CS (OR = 1.017 [1.006-1.027]). Intravenous fluid replacement was administered to the patients with CS at a dose of 4000 cc/m2/day. Hypokalemia was observed in 51.9% of the CS patients on the third day. All patients with AKI showed improvement and no deaths were reported.

Conclusions: Hyponatremia and increase in inflammation markers associated with CS may be observed. An increase in myoglobin levels was identified as a risk factor for CS. Hypokalemia may be seen as a complication of vigorous fluid therapy during hospitalization.

Keywords: Acute kidney injury; Crush Syndrome; Earthquake; Myoglobin.

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Conflict of interest statement

Authors declare no conflict of interest.

Figures

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A higher resolution version of the Graphical abstract is available as Supplementary information
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