Publications by authors named "Hui K Yap"

Background: In endemic COVID-19, immunocompromised children are vulnerable until vaccinated but the optimal primary vaccination regime and need for booster doses remains uncertain.

Methods: We recruited 19 immunocompromised children (post-solid organ transplantation, have autoimmune disease or were on current or recent chemotherapy for acute lymphoblastic leukemia), and followed them from the start of primary vaccination with BNT162b2 mRNA SARS-CoV-2 until 1-year post-vaccination. We investigated the quality of vaccine immunogenicity, and longevity of hybrid immunity, in comparison to healthy children.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigated the effectiveness and safety of rituximab for treating childhood steroid-resistant nephrotic syndrome (SRNS) across 28 pediatric nephrology centers globally.
  • Researchers found that children with a longer history of calcineurin inhibitors (CNIs) treatment before rituximab had lower remission rates compared to those with shorter treatment periods.
  • Overall, rituximab showed enhanced remission rates in a portion of SRNS patients, was mostly safe, and achieving complete remission was linked to better kidney survival outcomes.
View Article and Find Full Text PDF

Infection-related complications remain the most significant cause for morbidity and technique failure in infants, children and adolescents who receive maintenance peritoneal dialysis (PD). The 2024 update of the Clinical Practice Guideline for the Prevention and Management of Peritoneal Dialysis Associated Infection in Children builds upon previous such guidelines published in 2000 and 2012 and provides comprehensive treatment guidance as recommended by an international group of pediatric PD experts based upon a review of published literature and pediatric PD registry data. The workgroup prioritized updating key clinical issues contained in the 2012 guidelines, in addition to addressing additional questions developed using the PICO format.

View Article and Find Full Text PDF
Article Synopsis
  • Gram-negative peritonitis (GNP) significantly affects children on long-term peritoneal dialysis, with a study analyzing 379 cases from 308 children across 28 countries showing that 74% responded well to initial treatment.
  • Risk factors for treatment failure include severe abdominal pain and bacterial resistance, while monotherapy with cefazolin yielded similar recovery rates as broader-spectrum antibiotics.
  • The study advocates for personalized empiric treatment based on susceptibility data and suggests that narrowing antibiotic therapy does not compromise patient outcomes.
View Article and Find Full Text PDF

Key Points: Despite a high need and interest in point-of-care ultrasound (POCUS) in trainees and faculty of Pediatric Nephrology, the majority are not receiving POCUS training. There is a need to establish a structured pediatric nephrology POCUS program for clinicians and fellows. This study suggests a blueprint of POCUS curriculum which can serve as a foundation for POCUS education in pediatric nephrology centers worldwide.

View Article and Find Full Text PDF
Article Synopsis
  • Focal segmental glomerular sclerosis (FSGS) is a leading cause of nephrotic syndrome that can lead to end-stage kidney disease and is known to recur after kidney transplants, increasing the risk of graft loss and patient complications.* -
  • A research group conducted a comprehensive review of existing literature to establish guidelines focused on the causes, risk factors, and management strategies for recurrent FSGS, examining 614 studies and narrowing it down to 221 relevant ones.* -
  • The resulting recommendations indicate the need for further studies to enhance and solidify the guidelines for managing recurrent FSGS in transplant patients.*
View Article and Find Full Text PDF

Long-term humoral immunity is mediated by short-lived plasma cells (replenished by memory B cells) and long-lived plasma cells. Their relative contributions are uncertain for immunity to SARS-CoV-2, especially given the widespread use of novel mRNA vaccines. Yet, this has far-reaching implications in terms of the need for regular booster doses in the general population and perhaps even revaccination in patients receiving B cell-depleting therapy.

View Article and Find Full Text PDF

Objectives: Nutrition plays a vital role in the outcome of critical illness in children, particularly those with acute kidney injury. Currently, there are no established guidelines for children with acute kidney injury treated with continuous kidney replacement therapy. Our objective was to create clinical practice points for nutritional assessment and management in critically ill children with acute kidney injury receiving continuous kidney replacement therapy.

View Article and Find Full Text PDF
Article Synopsis
  • Nutrition is crucial for critically ill children, especially those with acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT), but there are no specific guidelines currently in place for their nutritional management.
  • A comprehensive literature review was conducted, and insights from a panel of experts in pediatric nephrology and nutrition were utilized to create clinical practice points specifically focused on nutritional assessment and management for these patients.
  • The final output includes 44 clinical practice points that address nutrition assessment, energy needs, and nutrient intake, developed through the modified Delphi method using existing research and expert consensus.
View Article and Find Full Text PDF

The nutritional status and management of children with chronic kidney disease (CKD) are complex and require a combined pediatric nephrology team work approach with physicians, nutritionists, nurses, and physical/occupational therapists. Prospective observational studies such as Children with CKD in the US, the 4C study in Europe and the International Pediatric Peritoneal Dialysis Network have advanced the field. However, most recommendations and guidelines from international task forces such as Kidney Diseases Improving Global Outcomes and Pediatric Renal Nutrition Taskforce are opinion-based rather than evidence-based.

View Article and Find Full Text PDF

Background: Long-term outcomes after multiple courses of rituximab among children with frequently relapsing, steroid-dependent nephrotic syndrome (FRSDNS) are unknown.

Methods: A retrospective cohort study at 16 pediatric nephrology centers from ten countries in Asia, Europe, and North America included children with FRSDNS who received two or more courses of rituximab. Primary outcomes were relapse-free survival and adverse events.

View Article and Find Full Text PDF

Management of acute liver failure (ALF) and acute on chronic liver failure (ACLF) in the pediatric population can be challenging. Kidney manifestations of liver failure, such as hepatorenal syndrome (HRS) and acute kidney injury (AKI), are increasingly prevalent and may portend a poor prognosis. The overall incidence of AKI in children with ALF has not been well-established, partially due to the difficulty of precisely estimating kidney function in these patients.

View Article and Find Full Text PDF
Article Synopsis
  • * Methods: Researchers conducted a thorough review of 60 studies focusing on the plasma/serum of 837 aHUS patients at diagnosis to analyze the presence of specific biomarkers.
  • * Results: The findings suggest that aHUS is characterized by lower levels of biomarkers such as C3 and CH50, and higher levels of C5a and D-dimer, which could form a comprehensive profile for better diagnosis of the condition.
View Article and Find Full Text PDF

COVID-19 has challenged the global healthcare system through rapid proliferation and lack of existing treatment resulting in over 180 million cases and 3.8 million deaths since December 2019. Although pediatric patients only comprise 1%-2% of diagnosed cases, their incidence of acute kidney injury ranges from 8.

View Article and Find Full Text PDF

Kidney replacement therapy (KRT) is used to provide supportive therapy for critically ill patients with severe acute kidney injury and various other non-renal indications. Modalities of KRT include continuous KRT (CKRT), intermittent hemodialysis (HD), and sustained low efficiency daily dialysis (SLED). However, circuit clotting is a major complication that has been investigated extensively.

View Article and Find Full Text PDF

Introduction: The slow increase in use of telemedicine began to expand rapidly, along with reimbursement changes, during the coronavirus disease-2019 (COVID-19) pandemic. Standardized protocols for these services are lacking but are needed for effective and equitable health care. In this study, we queried pediatric nephrologists and their patients about their telemedicine experiences during the pandemic.

View Article and Find Full Text PDF

Acute kidney injury continues to be a highly occurring disease in the intensive care unit, specifically affecting up to a third of critically ill neonates as per various studies. Although first-line treatments of acute kidney injury are noninvasive, kidney replacement therapy (KRT) is indicated when conservative management modes fail. There are various modalities of KRT which can be used for neonatal populations, including peritoneal dialysis, hemodialysis, and continuous KRT.

View Article and Find Full Text PDF

Kidney disease is a global public health concern across the age spectrum, including in children. However, our understanding of the true burden of kidney disease in low-resource areas is often hampered by a lack of disease awareness and access to diagnosis. Chronic kidney disease (CKD) in low-resource settings poses multiple challenges, including late diagnosis, the need for ongoing access to care and the frequent unavailability of costly therapies such as dialysis and transplantation.

View Article and Find Full Text PDF

Unlabelled: The increasing numbers of individuals diagnosed with Autism Spectrum Disorder (ASD) has foreshadowed a greater need for effective intervention procedures to aid learning.

Purpose: This study compared the effectiveness of video modelling (VM) and virtual reality (VR) for teaching adults with ASD.

Methods: Using an alternating treatments design without baseline two participants completed paper folding projects of varying difficulty following exposure to either VM or VR task modelling.

View Article and Find Full Text PDF