Bakkaloglu, SADelibas, ADöven, SSTaner, SYavuz, SErfidan, GVatansever, EDAynaci, FYílmaz, KTasdemir, MAkaci, OAkinci, NGüven, SÇiçek, NDursun, IKelesoglu, ESancaktar, MAlaygut, DSaygili, SYavascan, ÖYilmaz, AGülleroglu, KErtan, PDemir, BKPoyrazoglu, HPinarbasi, SGençler, ABastug, FGünay, NÇelegen, KNoyan, AParmaksiz, GAvci, BÇayci, FSBayrakçi, UÖzlü, SGAksoy, ÖYYel, SInal, GAKöse, SBayazit, AKAtmis, BSaribas, EÇagli, ÇTabel, YElmas, ATSelçuk, SZKiliç, BDKara, MABüyükçelik, MBalat, ATiryaki, BDErdogdu, BAksu, BMahmudova, GDursun, HCandan, CGöknar, NMutlubas, FÇamlar, SABasaran, CAkbulut, BBDüzova, AGülhan, BOruç, ÇPeru, HAlpay, HTürkkan, ÖNGülmez, RÇelakil, MDogan, KBilge, IPehlivanoglu, CBüyükkaragöz, BLeventoglu, EAlpman, NZeybek, CTülpar, SGülsan, RYÇKara, AGürgöze, MKÖnder, ENAAtikel, YÖPul, SSönmez, FYildiz, GAkman, SElmaci, MKüçük, NYüksel, SKavaz, ANalçacioglu, HAlparslan, CDinçel, NElhan, AHSever, L2024-07-182024-07-180931-05091460-2385http://akademikarsiv.cbu.edu.tr:4000/handle/123456789/11066Background. Two earthquakes on 6 February 2023 destroyed 10 cities in Turkiye. We report our experience with pediatric victims during these catastrophes, with a focus on crush syndrome related-acute kidney injury (Crush-AKI) and death. Method. Web-based software was prepared. Patient demographics, time under rubble (TUR), admission laboratory data, dialysis, and kidney and overall outcomes were recorded. Results. A total of 903 injured children (median age 11.62 years) were evaluated. Mean TUR was 13 h (interquartile range 32.5, max 240 h). Thirty-one of 32 patients with a TUR of >120 h survived. The patient who was rescued after 10 days survived. Two-thirds of the patients were given 50 mEq/L sodium bicarbonate in 0.45% sodium chloride solution on admission day. Fifty-eight percent of patients were given intravenous fluid (IVF) at a volume of 2000-3000 mL/m(2) body surface area (BSA), 40% at 3000-4000 mL/m(2) BSA and only 2% at >4000 mL/m(2) BSA. A total of 425 patients had surgeries, and 48 suffered from major bleeding. Amputations were recorded in 96 patients. Eighty-two and 66 patients required ventilator and inotropic support, respectively. Crush-AKI developed in 314 patients (36% of all patients). In all, 189 patients were dialyzed. Age >15 years, creatine phosphokinase (CK) >= 20 950 U/L, TUR >= 10 h and the first-day IVF volume <3000-4000 mL/m2 BSA were associated with Crush-AKI development. Twenty-two deaths were recorded, 20 of 22 occurring in patients with Crush-AKI and within the first 4 days of admission. All patients admitted after 7 days survived. Conclusions. These are the most extensive pediatric kidney disaster data obtained after an earthquake. Serum CK level was significantly associated with Crush-AKI at the levels of >20 950 U/L, but not with death. Adolescent age and initial IVF of less than 3000-4000 mL/m(2) BSA were also associated with Crush-AKI. Given that mildly injured victims can survive longer periods in the disaster field, we suggest uninterrupted rescue activity for at least 10 days.EnglishMARMARA EARTHQUAKEDISASTER NEPHROLOGYCRUSH-SYNDROMERENAL-FAILUREVICTIMSCHILDRENMANAGEMENTTRAUMAIRANBAMArticle; Early Access