{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:01:49Z","timestamp":1793102509593,"version":"4.5.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Nephrol"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>There are limited studies evaluating hyperglycemia in children treated with continuous kidney replacement therapy (CKRT). We evaluated the association of hyperglycemia with kidney outcomes in critically ill children treated with CKRT for acute kidney injury (AKI) or fluid overload.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Secondary analysis of the multicenter retrospective observational Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) study (34 centers, 9 countries). Primary exposure was hyperglycemia on days 0\u20137 of CKRT (average serum glucose of\u2009\u2265\u2009150\u00a0mg\/dL). Average serum glucose\u2009&lt;\u2009150\u00a0mg\/dL was defined as euglycemic. We stratified the hyperglycemic group with cut-offs\u2009\u2265\u2009180\u00a0mg\/dL,\u2009\u2265\u2009200\u00a0mg\/dL, or\u2009\u2265\u2009250\u00a0mg\/dL. The primary outcome was MAKE-90 (death by 90\u00a0days or persistent kidney dysfunction [&gt;\u2009125% baseline serum creatinine, or dialysis dependence]).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of 985 participants, 48% (473) had average serum glucose\u2009&gt;\u2009150\u00a0mg\/dL during days 0\u20137 of CKRT. There were higher rates of death in the hyperglycemic group (44% vs. 32%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and longer length of stay among survivors (42 vs. 38\u00a0days, <jats:italic>p<\/jats:italic>\u2009=\u20090.017) compared to the euglycemic group. Those with average glucose\u2009\u2265\u2009150\u00a0mg\/dL had higher unadjusted odds of MAKE-90 (OR: 1.36, 95% CI 1.02\u20131.81); this finding did not remain after multivariate adjustment. Those with average glucose\u2009\u2265\u2009180\u00a0mg\/dL had higher adjusted odds of MAKE-90 (aOR: 1.44, 95% CI 1.02\u20132.04). In adjusted analysis, each 10\u00a0mg\/dL increase in glucose was associated with 3% increased odds of MAKE-90.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Hyperglycemia is associated with worse kidney outcomes among young persons on CKRT for AKI or fluid overload. Further studies are needed to evaluate the causality and determine appropriate glucose ranges in this high-risk population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s00467-025-06777-3","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T06:00:24Z","timestamp":1745474424000},"page":"2957-2966","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hyperglycemia and kidney outcomes in critically ill children and young adults on continuous kidney replacement therapy"],"prefix":"10.1007","volume":"40","author":[{"given":"Shrea","family":"Goswami","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja 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For full disclosure, we provide here an additional list of other author commitments and funding sources that are not directly related to this study: Katja M. Gist is a consultant for Bioporto Diagnostics and Potrero Medical and receives funding from the Gerber Foundation. Shina Menon is a consultant for Medtronic, Inc and Nuwellis, Inc and receives funding from the Gerber Foundation. Michelle C. Starr receives funding from the National Institutes of Health (NIDDK and NHLBI). Petter Bjornstad reports serving or having served as a consultant for AstraZeneca, Bayer, Bristol-Myers Squibb, Boehringer Ingelheim, Eli Lilly, LG Chemistry, Sanofi, Novo Nordisk, and Horizon Pharma. P.B. also serves or has served on the advisory boards and\/or steering committees of AstraZeneca, Bayer, Boehringer Ingelheim, Novo Nordisk, and XORTX. P.B. receives funding from National Institute of Health (NIDDK, NIEHS, NHLBI), Breakthrough T1D (formerly JDRF), American Heart Association and American Diabetes Association. Danielle E. Soranno receives funding from the Engineering in Medicine Program at Indiana University and Purdue University. Nicholas J. Ollberding provides statistical consulting services to SeaStar Medical Inc. No other disclosures were reported. Data cleaning and management supported in kind by the CCHMC Heart Institute Research Core. Statistical analyses supported by internal CCHMC funding (PI Gist).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}}]}}