This study adds to the small existing literature demonstrating the validity of actigraphy in middle childhood. Although actigraphy shows good sensitivity (ability to detect sleep), specificity (ability to detect wake) is poor in this age group. Further, the results highlight the importance of considering whether a child has PLMS when interpreting actigraphic data, as well as the difficulties in accurately capturing sleep onset latency with actigraphy.

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Study Objectives: To determine whether adherence to positive airway pressure (PAP) differs in children with developmental disabilities (DD) compared to typically developing (TD) children. Methods: PAP adherence of 240 children initiated on PAP for obstructive sleep apnea (OSA) was retrospectively analyzed. Adherence between groups, expressed as percentage of nights used and hours of usage on nights used at 3 and 6 months, was compared. Predictive factors of adherence were studied using a median regression model. Results: A total of 103 children with DD (median [interquartile range] age = 7.9 [3.2-13.1] years) and 137 .1], P = .005) children were included. Percentage of nights used was significantly higher in children with DD at 3 (DD = 86.

Background Hepcidin, a key iron regulatory protein, is elevated in patients with chronic kidney disease (CKD). Its role in the development and progression of the anemia of CKD in children remains poorly defined. Methods Cross-sectional and longitudinal study in children aged 1–16 years with stage 2–4 CKD in the Chronic Kidney Disease in Children (CKiD) cohort (n=133) with hepcidin measured at baseline and hemoglobin (HGB) measured annually in follow-up. Anemia was defined as HGB < 5th percentile for age/sex OR treatment with an erythropoiesis stimulating agent (ESA). Results Hepcidin levels correlated negatively with glomerular filtration rate (GFR) (r=−0.22, p=0.01) and positively with ferritin (r=0.67, p<0.001). At the lower end of the GFR spectrum at baseline (10th percentile, 27.5 ml/min/1.73m2), higher hepcidin was associated with a 0.87 g/dL decrease in HGB during follow-up (95% CI −1.69, −0.05 g/dL, p=0.038). At higher GFR percentiles there was no significant association between baseline hepcidin and HGB during follow-up. Among 90 non-anemic subjects at baseline, 23.3% developed incident anemia. In subjects with GFR ≤ the median, a higher hepcidin level was associated with an increased risk for incident anemia (at 10th %ile GFR, HR 3.471, 95% CI 1.228, 9.810, p=0.019; at 25th %ile GFR HR 2.641, 95% CI 1.213, 5.750, p=0.014; at 50th %ile GFR, HR 1.953, 95% CI 1.011, 3.772, p=0.046). Among subjects with GFR in the 75th percentile or above, incrementally higher baseline hepcidin was not associated with increased anemia risk. Conclusions Higher hepcidin levels are associated with a decreased HGB and an increased risk for incident anemia, and this association is most significant among subjects with lower GFR.

After correcting serum creatinine for fluid balance and adjusting for surgical complexity, LFR performs fairly at 2 hours, whereas at 6 hours, LFR is a good AKI predictor. Prospective studies are needed to validate whether diuretic responsiveness predicts AKI.