BMC Nephrology (Jun 2025)
Pre-earthquake kidney function is a predictor of outcomes in earthquake-related crush syndrome
- Ramazan Daniş,
- Savaş Öztürk,
- İsmail Koçyiğit,
- Jehat Kılıç,
- Merve Civan,
- Tuncay Şahutoğlu,
- Dilek Torun,
- Engin Onan,
- Ahmet Alper Kıykım,
- Simal Köksal Cevher,
- Gürsel Yıldız,
- Zeynep Ebru Eser,
- Fatma Betül Güzel,
- Süleyman Karaköse,
- Tolga Yıldırım,
- Mehmet Polat,
- Ebru Gök Oğuz,
- Ali Gürel,
- Yasemin Coşkun Yavuz,
- Hasan Kayabaşı,
- Zehra Eren,
- Mehmet Rıza Altıparmak,
- Nurhan Seyahi,
- Mehmet Küçüksu,
- Sibel Gökçay Bek,
- Esra Akçalı,
- İrem Pembegül,
- Zeki Aydın,
- Elif Arı Bakır,
- Saliha Yıldırım,
- Sabahat Ecder,
- Mehmet Horoz,
- Funda Sarı,
- Yavuz Ayar,
- Murat Tuğcu,
- Ayça İnci,
- Numan Görgülü,
- Nedim Yılmaz Selçuk,
- Gülizar Şahin,
- Cuma Bülent Gül,
- Hamat Dheir,
- Özdem Kavraz,
- Abdülkadir Ünsal,
- Sedat Üstündağ,
- Ali Rıza Odabaş,
- Serhan Tuğlular
Affiliations
- Ramazan Daniş
- Department of Internal Medicine, Division of Nephrology, Gazi Yasargil Educational Research Hospital
- Savaş Öztürk
- Division of Nephrology, Department of Internal Medicine, Istanbul University
- İsmail Koçyiğit
- Department of Internal Medicine, Division of Nephrology, Erciyes University
- Jehat Kılıç
- Department of Internal Medicine, Gazi Yasargil Educational Research Hospital, Diyarbakır
- Merve Civan
- Department of Internal Medicine, Kayseri City Hospital
- Tuncay Şahutoğlu
- Department of Nephrology, Mehmet Akif Inan Training and Research Hospital
- Dilek Torun
- Department of Nephrology, Adana Turgut Noyan Training and Research Hospital, Baskent University
- Engin Onan
- Department of Nephrology, Adana Turgut Noyan Training and Research Hospital, Baskent University
- Ahmet Alper Kıykım
- Department of Internal Medicine, Division of Nephrology, Training and Research Hospital, Mersin University
- Simal Köksal Cevher
- Department of Nephrology, University of Health Sciences, Ankara Bilkent City Hospital
- Gürsel Yıldız
- Hamidiye Faculty of Medicine, Basaksehir Cam and Sakura City Health Practice Research Center, Health Sciences University
- Zeynep Ebru Eser
- Department of Nephrology, Mersin City Training and Research Hospital
- Fatma Betül Güzel
- Department of Nephrology, Kilis State Hospital
- Süleyman Karaköse
- Konya City Health Practice Research Center, Health Sciences University
- Tolga Yıldırım
- Department of Internal Medicine, Division of Nephrology, Hacettepe University
- Mehmet Polat
- Department of Nephrology, Nevşehir State Hospital
- Ebru Gök Oğuz
- Department of Nephrology, Etlik City Hospital, Health Sciences University
- Ali Gürel
- Department of Internal Medicine, Division of Nephrology, Firat University Hospital
- Yasemin Coşkun Yavuz
- Department of Internal Medicine, Division of Nephrology, Selcuk University
- Hasan Kayabaşı
- Depatment of İnternet Medicine, Clinics of Nephrology
- Zehra Eren
- Division of Nephrology, Department of Internal Medicine, Alanya Training and Research Hospital, Alanya Alaaddin Keykubat University
- Mehmet Rıza Altıparmak
- Cerrahpasa Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Istanbul University
- Nurhan Seyahi
- Cerrahpasa Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Istanbul University
- Mehmet Küçüksu
- Department of Nephrology, Fethi Sekin City Hospital
- Sibel Gökçay Bek
- Department of Internal Medicine, Division of Nephrology, Kocaeli University
- Esra Akçalı
- Department of Nephrology, Tarsus State Hospital
- İrem Pembegül
- Department of Nephrology, Malatya Training and Research Hospital, Turgut Ozal University
- Zeki Aydın
- Department of Nephrology, Darıca Farabi Training and Research Hospital, Health Sciences University
- Elif Arı Bakır
- Department of Nephrology, Doktor Lütfi Kırdar City Hospital
- Saliha Yıldırım
- Department of Internal Medicine, Division of Nephrology, Gazi University
- Sabahat Ecder
- Department of Nephrology, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Medeniyet University
- Mehmet Horoz
- Adana Faculty of Medicine, Adana City Health Practice Research Center, Health Sciences University
- Funda Sarı
- Department of Internal Medicine, Division of Nephrology, Akdeniz University
- Yavuz Ayar
- Bursa Faculty of Medicine, Bursa City Health Practice Research Center, Health Sciences University
- Murat Tuğcu
- Department of Internal Medicine, Division of Nephrology, School of Medicine, Marmara University
- Ayça İnci
- Department of Nephrology, Antalya Training and Research Hospital
- Numan Görgülü
- Department of Nephrology, Bagcilar Training and Research Hospital, Health Sciences University
- Nedim Yılmaz Selçuk
- Department of Internal Medicine, Division of Nephrology, Necmettin Erbakan University
- Gülizar Şahin
- Department of Nephrology, Sultan Abdulhamid Han Research and Training Hospital, Health Sciences University
- Cuma Bülent Gül
- Department of Internal Medicine, Division of Nephrology, Bursa Uludag University
- Hamat Dheir
- Division of Nephrology, Sakarya University
- Özdem Kavraz
- Division of Nephrology, Giresun University
- Abdülkadir Ünsal
- Şişli Hamidiye Etfal Education and Research Hospital
- Sedat Üstündağ
- Division of Nephrology, Trakya University Faculty of Medicine
- Ali Rıza Odabaş
- Department of Nephrology, Sultan Abdulhamid Han Research and Training Hospital, Health Sciences University
- Serhan Tuğlular
- Department of Internal Medicine, Division of Nephrology, School of Medicine, Marmara University
- DOI
- https://doi.org/10.1186/s12882-025-04183-3
- Journal volume & issue
-
Vol. 26,
no. 1
pp. 1 – 9
Abstract
Abstract Background The devastating earthquakes in Kahramanmaraş, Türkiye, in February 2024, caused extensive trauma and loss of lives, causing unique challenges in the management of earthquake-related crush syndrome. The current study investigates the prognostic value of pre-earthquake kidney function for mortality prediction in patients diagnosed with crush syndrome. Methods A multi-center retrospective analysis was performed using data from 469 patients treated at 46 nephrology clinics. Pre-earthquake Kidney function, defined by serum creatinine and estimated glomerular filtration rate (eGFR) levels, was obtained from pre-earthquake health records. Clinical findings, laboratory parameters, complications, and survival probabilities were analyzed. Multivariate Cox regression was used to identify independent predictors of in-hospital mortality. Results The mean age of participants was 42.56 ± 16.92 years (Non-survivors: 50.46 ± 20.03 years, Survivors: 42.34 ± 16.80 years (p = 0.172)). The in-hospital mortality rate was 2.8%. Non-survivors exhibited significantly higher pre-earthquake creatinine levels than survivors (1.04 ± 0.61 mg/dL vs. 0.77 ± 0.33 mg/dL, p = 0.03), with lower eGFR (85.2 ± 34.7 mL/min/1.73 m² vs. 115.8 ± 39.4 mL/min/1.73 m², p = 0.008). Compared with survivors, non-survivors had higher incidences of AKI (92.3% vs. 61.6%, p = 0.037) and more severe metabolic disturbances, including hyperkalemia (5.41 ± 1.72 mmol/L vs. 5.13 ± 0.98 mmol/L, p = 0.008). Regression analysis revealed that pre-earthquake creatinine (HR: 9.121, 95% CI: 2.686–30.970, p < 0.001) and potassium levels at admission (HR: 3.338, 95% CI: 1.540–7.232, p = 0.002) were independent predictors of mortality. Conclusions Pre-earthquake kidney function significantly predicts mortality in crush syndrome patients, highlighting the importance of baseline kidney assessment in disaster preparedness.
Keywords
