Abstract

Objective: We retrospectively examined the nephrological conditions of the victims who applied to the Pediatric Nephrology Clinic in our hospital in İzmir after the February 6, 2023 Kahramanmaraş earthquake.

Method: Age, gender, time spent under debris, number of crushed extremities, presence of acute kidney injury (AKI), creatine kinase (CK) levels and prognosis of all patients were evaluated. 5% dextrose-0.45% NaCl solution was given as 1500 cc/m2/day if the CK levels of the children were between 1000-3000 U/L, and as 3000 cc/m2/day for those >3000 U/L. If the bicarbonate value is <25, alkalinization was achieved by applying NaHCO3 treatment to 50 mEq/L. If CK values fell below 3000 U/L, the amount of fluid was reduced by half, and if it was below 1000 U/L, it was discontinued. If blood gas pH is >7.50 and/or bicarbonate ≥30, alkalinization treatment is discontinued; if 25-30 it is halved.

Results: Of the total 33 pediatric patients, 48.5% were girls and 51.5% were boys. The children had a mean age of 9.0±3.9 years. The mean stay under the rubble was 17.00 (4.25-48.00) hours. The CK values of 23 patients were >1000 U/L at the time of admission. Six patients had acute kidney injuries at admission. Four patients received hemodialysis and/or hemodiafiltration treatment. The CK values returned to normal in 5.0 (3.0-8.0) days in the patients who received fluid and alkalinization treatments. The serum creatinine values of all patients normalized.

Conclusion: Even in the case of concomitant AKI in crush syndrome developing after an earthquake, full recovery can be achieved with aggressive fluid and alkalinization treatment.