Pediatric renal abscess is an uncommon but potentially serious infection that may result in permanent renal injury. Despite advances in imaging, its contemporary clinical features and long-term renal outcomes have not been comprehensively described. We conducted a structured descriptive review of reports published between January 2000 and June 2026 using PubMed/MEDLINE and Web of Science, identifying 65 articles describing 361 pediatric cases eligible for analysis. Renal abscess occurred across all pediatric age groups, with a slight female predominance. Underlying urinary tract abnormalities were reported in a substantial proportion of cases, although reporting was incomplete; vesicoureteral reflux (VUR) was identified in 33.1
Bone mineral disease is highly prevalent and a key contributor to morbidity and mortality in the pediatric hemodialysis population. Clinical tools to manage this are limited, with no consensus on optimal parathyroid hormone (PTH) targets to guide therapies. Limited data suggest infants and young children may be more prone to hyperparathyroidism but evidence is lacking. A longitudinal retrospective cohort study was conducted to investigate relationships between PTH, age, and bone outcomes in a cohort of children ages 0–12 years who received hemodialysis between 2002 and 2023. Records were reviewed for biochemical bone mineral values and adverse bone outcomes, defined by fracture and/or evidence of bone disease on imaging. The study included 638 observations of 52 patients with median age 8.4 years (IQR 3.4, 11.3). Severe hyperparathyroidism (PTH > 1000 pg/mL) was more common in children 0–3 years old (30
Characterizing gene–metabolite–cardiac associations in childhood chronic kidney disease (CKD) has the potential to identify new research directions or therapeutic targets for mitigating the excessive cardiovascular risk in childhood CKD. The Chronic Kidney Disease in Children (CKiD) is a prospective cohort that recruited children with eGFR 30–90 ml/min/1.73 m2 across 54 North American centers. Predictor and outcome variables included genotypes, metabolite levels, left ventricular mass index (LVMI) z-score, and left ventricular filling pressure (E/e’). Multivariable linear regression analyses assessed metabolite associations with either LVMI z-score or E/e’, adjusting for age, sex, CKD duration, glomerular etiology, renin-angiotensin-aldosterone-system blockade, hypertension, anemia, dyslipidemia, eGFR, and proteinuria. Significance was based on the Benjamini–Hochberg False Discovery Rate <0.05. Metabolites associated with cardiac markers were carried forward for a metabolite–genome-wide association study (mGWAS). Linear regression calculated the residual metabolite variability not explained by age, sex, and eGFR. Linear regression assessed metabolite residual variability versus genetic variant dosage at the Bonferroni-corrected genome-wide significance threshold (corrected for number of metabolites assessed). 556 unique participants with 574 metabolites and 8.4 million SNPs were included. Sphingomyelin (d18:2/d18:1) and hypotaurine were associated with LVMI z-score. Isobutyrylglycine and 3beta-hydroxy-5-cholestenoate were associated with E/e’. Multiple genetic variants associated with these metabolites at p < 1.25E-8 (p < [5E-8]/4, Bonferroni-corrected genome-wide significance threshold). We identified metabolites associated with cardiac markers in children with CKD. We identified genetic associations with variability in these metabolites. Collectively, these gene–metabolite associations suggest roles for inflammation, increased oxidative stress, mitochondrial and energy dysmetabolism, and gut microbial dysbiosis in mediating cardiac pathology in childhood CKD.
Acute kidney injury (AKI) is common among hospitalized children and is associated with adverse short- and long-term outcomes. Under-recognition of pediatric AKI and incomplete serum creatinine monitoring contribute to low follow-up rates. Our objectives were to evaluate AKI incidence, electronic health record documentation, and factors associated with creatinine re-measurement after AKI onset among hospitalized children. Retrospective cohort study of all hospitalized children admitted to a quaternary pediatric hospital in Toronto, Canada, between January 2021 and December 2022. Children were excluded if they were <3 months of age, had pre-existing chronic kidney disease, or had no serum creatinine measurements during hospitalization. The primary exposure was AKI by KDIGO criteria. The primary outcome was repeat creatinine measurement within 1-day of AKI onset. Secondary outcomes included repeat creatinine measurements by different post-AKI timepoints and kidney recovery by discharge. Among 8992 hospitalized children, 1080 (12
Electronic cigarette use is increasingly common among adolescents and is associated with a widening range of toxic effects, although renal complications remain poorly characterized and are rarely confirmed histologically in this age group. We describe a previously healthy 14-year-old boy, a regular e-cigarette user, who developed oliguria, dark-colored urine, severe hypertension, seizures, and pulmonary infiltrates two days after his last use. Serum creatinine rose to 10.6 mg/dL, requiring hemodialysis. The presentation raised concern for a pulmonary–renal syndrome, prompting empiric corticosteroids and plasma exchange. However, serological testing was negative, urinary β2-microglobulin was markedly elevated, and kidney biopsy showed acute tubular injury without glomerular or immune-mediated disease. Immunosuppression was withdrawn, and kidney function recovered completely, remaining normal at 18 months. This case shows that vaping-associated acute tubular injury can mimic a pulmonary–renal syndrome and highlights the value of kidney biopsy in adolescents with unexplained severe acute kidney injury.
