Evidence map›Paper›PMID 41807663›Full record

Observational studyPediatric nephrology (Berlin, Germany)2026

Management of children and adolescents with failing kidney allografts-a review of current practice across Europe.

Zainab Arslan, Agnieszka Prytula, Anne Laure Sellier-Leclerc, Antonia Bouts, Augustina Jankauskiene, Ariane Zaloszyc, Alexander D Lalayiannis, Brankica Spasojevic, Claus Peter Schmitt, Colette Smith and 21 more

Abstract readMulticenter StudyObservational Study
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In one paragraph

Observational study in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors.

Zainab ArslanDepartment of Paediatric Nephrology, Great Ormond Street Hospital, Level 7, Southwood Building, WC1N 3JH, London, UK. Zainab.arslan@gosh.nhs.uk.ORCID http://orcid.org/0000-0002-1126-3995
Agnieszka PrytulaDepartment of Paediatric Nephrology and Rheumatology, Ghent University Hospital, Ghent, Belgium.
Anne Laure Sellier-LeclercPediatric Nephrology Department, Hôpital Femme Mère Enfants, HCL, Lyon, France.
Antonia BoutsDepartment of Pediatric Nephrology, Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, the Netherlands.
Augustina JankauskienePediatric Center, Institute of Clinical Medicine, Vilnius university, Vilnius, Lithuania.
Ariane ZaloszycPediatric Nephrology Unit, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
Alexander D LalayiannisDepartment of Paediatric Nephrology, Birmingham Children's Hospitals NHS Foundation Trust, Birmingham, UK.
Brankica SpasojevicDepartment of Paediatric Nephrology, University Children's Hospital, Belgrade, Serbia.
Claus Peter SchmittPediatric Nephrology, Center for Pediatric and Adolescent Medicine, Clinics 1, Medical Faculty Heidelberg, University Hospital Heidelberg, Heidelberg, Germany.
Colette SmithUCL Institute for Global Health, London, UK.
Diletta Domenica TorresPaediatric Nephrology and Dialysis Unit, Policlinico of Bari-Giovanni XXIII Children Hospital, Bari, Italy.
Elisa BenettiPaediatric Nephrology, Padua University Hospital, Padua, Italy.
Esra BaskinDepartment of Paediatric Nephrology, Baskent University, Ankara, Turkey.
Helen JonesDepartment of Paediatric Nephrology, Evelina London Children's Hospital, London, UK.
Isabella GuzzoDialysis and Transplant Unit, Division of Nephrology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.ORCID http://orcid.org/0000-0003-4960-3083
iSMAİL DursunDepartment of Pediatric Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey.
Kai KrupkaDepartment of Paediatrics I, Medical Faculty, University Children's Hospital Heidelberg, Heidelberg University, Heidelberg, Germany.
Lucy PlumbPopulation Health Sciences, University of Bristol Medical School, Bristol, UK.
Jérôme HarambatPaediatric Nephrology Unit, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
Moritz ScheererDepartment of Paediatric Nephrology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Maria Sameiro FariaDepartment of Paediatric Nephrology, Centro Materno-Infantil do Norte, Unidade Local de Saúde Santo António, Porto, Portugal.
Martin ChristianDepartment of Paediatric Nephrology, Nottingham Children's Hospital, Nottingham, UK.
Mohan ShenoyDepartment of Paediatric Nephrology, Royal Manchester Children's Hospital, Manchester, UK.
Nikoleta PrintzaPediatric Nephrology Unit, 1st Paediatric Department, Paediatric Nephrology Unit, Hippokration General Hospital, Aristotle University, Thessaloniki, Greece.
Nur CanpolatDepartment of Paediatric Nephrology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey.
Sara TestaPediatric Nephrology, Dialysis and Transplantation Unit, Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico, v. Commenda, 9, 20122, Milano, Italy.
Sevcan A BakkalogluDepartment of Paediatric Nephrology, Gazi University, Ankara, Turkey.
Thomas SimonPediatric Nephrology Unit, Toulouse University Hospital, Toulouse, France.
Vitor Hugo MartinsPediatric Nephrology Unit, Regina Margherita Children's Hospital, Turin, Italy.
Burkhard Tönshoff *Department of Paediatrics I, Medical Faculty, University Children's Hospital Heidelberg, Heidelberg University, Heidelberg, Germany.ORCID http://orcid.org/0000-0002-6598-6910
Rukshana Shroff *Department of Paediatric Nephrology, Great Ormond Street Hospital, Level 7, Southwood Building, WC1N 3JH, London, UK.ORCID http://orcid.org/0000-0001-8501-1072

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe medical management of failing kidney allografts is poorly understood even in adult patients with wide variations in practice. We studied failing kidney allografts in European children and provided insights into their management, including cardiovascular, CKD management, and changes to immunosuppression.

methodsA 3-year (2020-2023) retrospective study of current practices in the management of children with failing kidney allografts (with at least 1 year of follow-up) was conducted. A failing kidney allograft was defined as an eGFR < 30 mL/min/1.73 m

resultsA total of 119 patients from 27 European centres were included. At the time of allograft failure, 76% of patients were hypertensive, with 69% on antihypertensive medication(s). Of patients, 12%, 65%, and 29% were hyperphosphatemic, anemic, or acidotic, respectively. Phosphate binders, vitamin D analogs, iron supplementation, erythropoietin-stimulating agents, and alkali supplementation were used in 36%, 78%, 58%, 46%, and 71%, respectively. A variable practice of changing immunosuppressive drugs (at variable time points) after allograft failure was observed. At last follow-up, 47% of patients still had residual transplant function, 46% were on dialysis, 6% were re-transplanted, and 1% had died.

conclusionsManagement of children with failing kidney allografts is complex and practice varies across Europe. Our study paves the way for prospective studies looking at the effects of optimal management of blood pressure and CKD-MBD on allograft survival and the effects of immunosuppression changes on prospects for re-transplantation.

Indexed as

Graft RejectionKidney Failure, ChronicKidney TransplantationAdolescentAllograftsChildChild, PreschoolEuropeFemaleGraft SurvivalHumansImmunosuppressive AgentsMaleRegistriesRetrospective StudiesImmunosuppressive AgentsAdolescentsChildrenFailing allograftsFailing kidneysPost-transplantYoung people

Identifiers

PMID41807663

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.