{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:34:31Z","timestamp":1785429271014,"version":"3.56.0"},"reference-count":37,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82470249"],"award-info":[{"award-number":["82470249"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82270249"],"award-info":[{"award-number":["82270249"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"award":["82470249"],"award-info":[{"award-number":["82470249"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]},{"award":["82270249"],"award-info":[{"award-number":["82270249"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Open Research Fund Program of State Key Laboratory of Biocatalysis and Enzyme Engineering","award":["SKLBEE2021008"],"award-info":[{"award-number":["SKLBEE2021008"]}]},{"name":"Technology Project of Sichuan Province of China","award":["2024YFFK0367"],"award-info":[{"award-number":["2024YFFK0367"]}]},{"name":"Medical Research Project Plan of Sichuan Province","award":["S22068"],"award-info":[{"award-number":["S22068"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: To investigate prognostic risk factors and determine the incidence, clinical characteristics, and predictors of heart failure (HF) development in pediatric patients with end-stage kidney disease (ESKD) secondary to steroid-resistant nephrotic syndrome (SRNS). Materials and Methods: We conducted a retrospective cohort study of pediatric patients diagnosed with ESKD secondary to nephrotic syndrome (NS) between 2014 and 2020. Patients were stratified based on clinical outcomes and the occurrence of HF during follow-up. Comparative analyses of clinical characteristics, laboratory parameters, and cardiac assessments were performed across groups. Multivariate logistic regression was used to identify independent risk factors for HF development within the first year and for adverse prognosis at five years. Results: The cohort comprised 172 children with ESKD secondary to NS. Multivariate logistic regression identified HF as an independent risk factor for adverse long-term outcomes in pediatric patients with ESKD. During follow-up, HF developed in 27 patients (15.7%) within the first year after ESKD diagnosis, and in 45 patients (26.2%) by the end of five years. Early HF onset (within the first year) was associated with a significantly reduced five-year survival rate. Independent risk factors for HF development included elevated cardiac troponin I levels (OR = 6.786, 95% CI: 2.326\u201319.799), a history of cardiac arrhythmias (OR = 2.951, 95% CI: 1.260\u20136.912), and the presence of left heart enlargement (OR = 23.669, 95% CI: 2.876\u2013194.827), and valvular regurgitation at the initial post-ESKD diagnosis evaluation. Conclusions: HF is associated with markedly reduced survival. Crucially, our findings demonstrate that pre-existing cardiovascular structural abnormalities\u2014specifically left heart enlargement\u2014and elevated cTnI are robust, early predictors of HF. These findings necessitate a paradigm shift in pediatric ESKD management, we advocate for the implementation of systematic baseline echocardiographic and biomarker screening at the immediate onset of ESKD. Identifying these subclinical, yet modifiable, structural changes provide a critical therapeutic window for targeted anti-remodeling interventions to significantly improve long-term prognosis.<\/jats:p>","DOI":"10.3390\/medicina62061131","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T09:25:17Z","timestamp":1781083517000},"page":"1131","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of Heart Failure in Pediatric Patients with End-Stage Kidney Disease Secondary to Nephrotic Syndrome"],"prefix":"10.3390","volume":"62","author":[{"given":"Meng","family":"Wei","sequence":"first","affiliation":[{"name":"Ministry of Education Key Laboratory of Women and Children\u2019s Diseases and Birth Defects, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiping","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The First People\u2019s Hospital of Shuangliu District, West China Airport Hospital of Sichuan University, Chengdu 610207, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajun","family":"Shen","sequence":"additional","affiliation":[{"name":"Ministry of Education Key Laboratory of Women and Children\u2019s Diseases and Birth Defects, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wei","sequence":"additional","affiliation":[{"name":"Ministry of Education Key Laboratory of Women and Children\u2019s Diseases and Birth Defects, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3096-4287","authenticated-orcid":false,"given":"Yifei","family":"Li","sequence":"additional","affiliation":[{"name":"Ministry of Education Key Laboratory of Women and Children\u2019s Diseases and Birth Defects, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Guo","sequence":"additional","affiliation":[{"name":"Ministry of Education Key Laboratory of Women and Children\u2019s Diseases and Birth Defects, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease","volume":"105","year":"2024","journal-title":"Kidney Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s00467-011-1939-1","article-title":"Epidemiology of chronic kidney disease in children","volume":"27","author":"Harambat","year":"2012","journal-title":"Pediatr. 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