Evidence map›Paper›PMID 42776239›Full record

ArticlePediatric nephrology (Berlin, Germany)2026

IPNA clinical practice recommendations for the management of aHUS and secondary TMA in children.

Magdalena Riedl Khursigara, Laura F Alconcher, Khalid Alhasan, Atif Awan, Arvind Bagga, Admani Bashir, Olivia Boyer, Nilzete Liberato Bresolin, Paula A Coccia, Anne Durkan and 18 more

Abstract read
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In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Are some cases of atypical HUS actually undetected STEC-HUS?Pediatric nephrology (Berlin, Germany) · 2026
    Article
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

28 authors.

Magdalena Riedl KhursigaraDivision of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.
Laura F AlconcherNephrology Unit, Hospital Interzonal General Dr. José Penna, Bahía Blanca, Buenos Aires, Argentina.
Khalid AlhasanPediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Atif AwanDepartment for Paediatric Nephrology and Transplantation, Children's Health Ireland, Dublin, Ireland.
Arvind BaggaDivision of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Admani BashirDepartment of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
Olivia BoyerDepartment of Pediatric Nephrology, Hôpital Necker Enfants Malades, AP-HP and Université de Paris, Paris, France.
Nilzete Liberato BresolinDepartamento de Pediatria, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
Paula A CocciaDivision of Pediatric Nephrology, Department of Pediatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Anne DurkanDepartment of Nephrology, The Sydney Children's Hospitals Network, Sydney, NSW, Australia.
Larry A GreenbaumDivision of Pediatric Nephrology, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
Hee Gyung KangDepartment of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
Dieter HaffnerDepartment of Pediatric Kidney, Liver, Metabolic and Neurological Diseases, Hannover Medical School, Hannover, Germany.
Kazumoto IijimaDepartment of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
David KavanaghNational Renal Complement Therapeutics Centre, Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, Newcastle Upon Tyne, UK.
Priyanka KhandelwalDivision of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.
Sebastian LoosUniversity Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Alison Lap-Tak MaPaediatric Nephrology, Hong Kong Children's Hospital, Hong Kong, China.
Mignon McCullochRed Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Lilian Monteiro Pereira PalmaPediatric Nephrology, Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brazil.
Lars PapeDepartment of Pediatrics II, University Hospital of Essen, University of Duisburg- Essen, Essen, Germany.
Rupesh RainaDepartment of Nephrology, Akron Children's Hospital, Akron, OH, 44308, USA.
Hesham SafouhPediatric Nephrology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt.
Rezan TopalogluDivision of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Türkiye.
Nicole C A J van de KarAmalia's Children's Hospital, Department of Pediatric Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands.
Johan Van de WalleUniversity Hospital Ghent, Ghent, Belgium.
Jun OhUniversity Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Christoph LichtDivision of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada. christoph.licht@sickkids.ca.ORCID http://orcid.org/0000-0003-4168-3277

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtypical hemolytic uremic syndrome (aHUS) is a rare form of thrombotic microangiopathy (TMA) caused by complement-mediated injury of the vascular endothelium. We present Clinical Practice Recommendations (CPRs) and Practice Points (CPPs) for the diagnosis and management of aHUS and the related spectrum of secondary thrombotic microangiopathies (TMAs) in children, based on current evidence and expert consensus, developed by a panel of international experts including pediatric nephrologists associated with the International Pediatric Nephrology Association (IPNA), kidney pathologists, geneticists, and adult nephrologists. The guidance focuses exclusively on pediatric populations, in alignment with IPNA's scope, and does not address diagnoses exclusive to the adult age group.

methodsSix structured clinical questions were formulated using the PICO (Population, Intervention, Comparator, Outcomes) framework, guiding comprehensive literature reviews. Recommendations were developed through expert consensus using a modified Delphi process. Two predefined levels of agreement-agreement and strong agreement-were used, with consensus on either level requiring ≥ 80% concurrence among panel members.

resultsA total of 51 CPRs for the diagnosis and management of genetic aHUS, autoimmune aHUS, aHUS in the setting of kidney transplantation, and secondary TMA are presented. Additionally, 9 CPPs provide guidance for the management of secondary TMA. Importantly, all guidance is contextualized to also reflect the distinct epidemiology and healthcare landscapes of less well-resourced countries.

conclusionThese recommendations, based on global consensus, aim to standardize and provide guidance for the diagnostic work-up and treatment of aHUS and secondary TMAs in children worldwide, thus ultimately improving patient outcomes. In addition, this guidance supports implementation efforts in resource-limited settings and provides direction for future research.

Indexed as

Anti-Factor H autoantibodiesAtypical hemolytic uremic syndromeComplementThrombotic microangiopathy

Identifiers

PMID42776239

What OpenQuestion holds

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Registered trials

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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 OpenQuestion graph.