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. 2024 Dec;37(9):2579-2588.
doi: 10.1007/s40620-024-02043-1. Epub 2024 Aug 31.

Pediatric crush-related acute kidney injury and risk factors: a single center experience

Sevgin Taner  1 , Ulas Ozdemir  2 , Tugba Kandemir Gulmez  3 , Sercin Güven  4 , Neslihan Cicek  4 , Emre Kelesoglu  5 , Ilknur Arslan  6 , Umit Celik  3
Affiliations

Pediatric crush-related acute kidney injury and risk factors: a single center experience

Sevgin Taner et al. J Nephrol. 2024 Dec.

Abstract

Background and objectives: Crush injury, the most important trauma complication encountered in earthquake victims, occurs as a result of prolonged compression of muscle mass. Crush syndrome, resulting from crush injury, and acute kidney injury (AKI) are the most common causes of in-hospital deaths after earthquakes. The aim of this study is to convey our experience after the devastating Turkey-Syria earthquake and to identify the risk factors of crush syndrome and crush-related AKI.

Methods: Of the 1134 children admitted to the emergency department, 265 with crush injury were included the study. Demographic information, laboratory and clinical data of the patients were retrospectively analyzed.

Results: Mean age of the patients was 10.3 ± 4.9 years (134 females and 131 males). The median time spent under the rubble was 20 h. Crush syndrome developed in 135 (50.9%). Patients with crush syndrome were older and had higher body weight, respectively (p = 0.014, p = 0.044). Acute kidney injury was present in 157 (59.2%) patients. Thirty-two patients (12.1%) received kidney replacement therapy (KRT). The risk factors for the development of AKI Stage 3 were crush syndrome, abdominal trauma, and age.

Conclusion: This disaster taught us the importance of establishing in advance a national emergency disaster plan. Older pediatric earthquake victims with multiple trauma and severe crush syndrome should be closely followed-up for development of AKI and, if necessary, started on dialysis. Timely access to medical care, early fluid resuscitation, and effective use of dialysis treatment are essential.

Keywords: Acute kidney injury; Crush injury; Crush syndrome; Earthquake; Turkey–Syria earthquake.

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Conflict of interest statement

Declarations. Funding: The authors did not receive support from any organization for the submitted work. Conflict of interest: The authors have no conflicts of interest relevant to this article to disclose. Consent to participate: Informed consent was obtained from all individual participants included in the study and their legal guardians. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Adana City Education and Research Hospital. Authors’ contribution: All authors participated in the concept and design, analysis and interpretation of data, and drafting or revising of the manuscript. Conceptualization: Sevgin Taner; methodology: Sevgin Taner, Ulas Ozdemir; formal analysis and investigation: Ulas Ozdemir, Tugba Kandemir Gulmez, Ilknur Arslan; writing—original draft preparation: Sevgin Taner, Sercin Guven, Neslihan Cicek; writing—review and editing: Sevgin Taner, Sercin Guven, Neslihan Cicek, Emre Kelesoglu, Ilknur Arslan, Umit Celik; supervision: Sevgin Taner, Umit Celik. All authors read and approved the final manuscript.

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References

    1. Atmis B, Bayazit AK, Cagli Piskin C, Saribas E, Piskin FC, Bilen S, Ozgur Horoz O, Ekinci F, Turker I, Telefon HA, Unal I, Yilmaz HL, Narli N, Yildizdas D (2023) Factors predicting kidney replacement therapy in pediatric earthquake victims with crush syndrome in the first week following rescue. Eur J Pediatr 182(12):5591–5598. https://doi.org/10.1007/s00431-023-05250-3 - DOI - PubMed
    1. Taner S, Tabel Y, Bakkaloğlu SA (2023) The devastating Turkey–Syria earthquake from the perspective of pediatric nephrology. J Pediatr Res 10(4):244–248 - DOI
    1. Bartels SA, VanRooyen MJ (2012) Medical complications associated with earthquakes. Lancet 379(9817):748–757. https://doi.org/10.1016/S0140-6736(11)60887-8 . (Erratum in: Lancet; 2012 Feb 25;379(9817):712. PMID: 22056246) - DOI - PubMed
    1. He Q, Wang F, Li G, Chen X, Liao C, Zou Y, Zhang Y, Kang Z, Yang X, Wang L (2011) Crush syndrome and acute kidney injury in the Wenchuan earthquake. J Trauma 70(5):1213–1217. https://doi.org/10.1097/TA.0b013e3182117b57 . (discussion 1217–8) - DOI - PubMed
    1. Sever MS, Erek E, Vanholder R, Akoglu E, Yavuz M, Ergin H, Turkmen F, Korular D, Yenicesu M, Erbilgin D, Hoeben H, Lameire N (2002) Clinical findings in the renal victims of a catastrophic disaster: the Marmara earthquake. Nephrol Dial Transplant 17(11):1942–1949. https://doi.org/10.1093/ndt/17.11.1942 - DOI - PubMed

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