ABSTRACT This article explores the first five years of the Irish young people’s anti-abortion group Youth Defence. Using newspaper articles and archival sources, I illustrate how the group effectively mobilised the category of ‘youth’ in their activism. ‘Youth’ was used to excuse their militant activities and any violence associated with the group. I also argue here that while the group’s activism was profoundly influenced by American campaigners, their rhetoric and activism also embodied nationalist and Catholic tropes. The establishment of Youth Defence also marked a turning point in the anti-abortion movement in Ireland. As older strategies appeared to be losing momentum, the young activists used very imaginative ways of operating but also built on older activists’ methods such as the engagement with transnational connections. I show how the activism of these young people, while focused on the abortion issue, also represented a reaction against broader social and cultural change in Irish society. In subsequent sections, I focus on the activities of Youth Defence and show how their activism, which attracted significant media attention, represented a new wave of more militant anti-abortion activity in Ireland, which provoked tensions both among the public and within the wider anti-abortion movement. Fundamentally, the article aims to show that while the anti-abortion cause was the main reason for activists joining Youth Defence, it also enabled them to channel wider anxieties around young people’s experiences, national identity and changes in Irish society, into protest. In exploring the history of Youth Defence, this article contributes to the history of conservative activism in Ireland and the wider history of the anti-abortion movement.

While smartphones are ubiquitous, especially among young people, their usage has created new avenues for abuse. Technology-facilitated intimate partner violence (TFIPV) can lead to several negative impacts on physical and mental health. Studies have found higher victimization rates among young people and mixed results based on gender identity. This study examines various forms of TFIPV victimization among U.S. young adults, focusing on its associations with physical intimate partner violence (IPV), gender identity, and mental health. Using data from the Year-22 survey of the Future of Families and Child Wellbeing Study, our cross-sectional analysis included a sample of 1,053 young adults who were in a serious relationship, engaged, or married. Our findings highlight the link between TFIPV and physical IPV, as individuals who experienced physical IPV had almost 10 times the odds of experiencing TFIPV compared to those who had not experienced physical IPV. Young men reported TFIPV victimization rates at least two times greater than young women; however, worse mental health outcomes were found only among young women. Individuals with less education were more likely to experience TFIPV compared to individuals with college degrees, regardless of gender. Our results suggest the need to challenge the stereotype that men are less likely to be victims of TFIPV, a stereotype that discourages men from identifying as victims and seeking help. Prevention and intervention frameworks should move toward inclusive and gender-neutral approaches, while still acknowledging that the types of abuse may vary by gender. In addition, programming should highlight the different forms TFIPV can take and normalize open discussions about unhealthy digital relationship dynamics.

Consensus-based clinical practice guidelines recommend echocardiographic surveillance intervals based on aortic stenosis (AS) severity; however, real-world surveillance practices and associated outcomes remain poorly characterized. We evaluated AS echocardiographic surveillance patterns using validated natural language processing algorithms applied to echocardiogram reports from Kaiser Permanente Northern California between January 1, 2008, and September 30, 2017. Patients with prior aortic valve replacement (AVR) were excluded. Guideline concordance was based on the American College of Cardiology/American Heart Association (ACC/AHA) recommendations for surveillance frequency of patients with mild, moderate, and severe AS. Mild-moderate and moderate-severe AS were assigned to follow surveillance intervals of the more severe AS classification. We used multivariable Cox proportional hazards regression to examine associations between guideline concordance and all-cause death and receipt of AVR. Among 20 571 patients with AS (mean age 75.7±11.2 years, 48% women), rates of guideline concordance were 74% for mild AS, 51% for mild-moderate AS, 63% for moderate AS, 51% for moderate-severe AS, and 49% for severe AS. Male sex, younger age, having a cardiologist, and certain comorbid conditions were positively associated with guideline concordance. During median follow-up of 5.2 (interquartile range, 3.0-7.4) years, patients who were guideline concordant experienced 1929 (28.8%) deaths and 1783 (26.6%) AVRs, while those not concordant experienced 3683 (42.2%) deaths and 1266 (14.5%) AVRs. Guideline concordance was associated with lower adjusted all-cause death for those with at least moderate AS (moderate: adjusted hazard ratio [aHR], 0.76 [95% CI, 0.68-0.85]; moderate-severe: aHR, 0.70 [0.54-0.91]; severe: aHR, 0.62 [0.51-0.76]), and higher rates of AVR across all AS severity levels (mild: aHR, 2.23 [1.93-2.57]; mild-moderate: aHR, 1.56 [1.22-1.99]; moderate: aHR, 1.45 [1.28-1.64]; moderate-severe: aHR, 2.09 [1.62-2.69]; severe: aHR, 1.95 [1.60-2.36]). Implementation of the current American College of Cardiology/American Heart Association guideline-recommended echocardiographic surveillance frequency in adults with AS is associated with improved outcomes yet remains suboptimal in real-world settings.

The mental health treatment gap is an important issue for young people in the East Mediterranean Region as financial constraints and cultural factors continue to play a limiting role. This paper examined predictors and barriers for help-seeking for mental health problems in children and adolescents in Lebanon. The Psychopathology in Children and Adolescents in Lebanon Study, a nationally-representative household sample of n = 1,517 youth aged 5-17 years, was used. Parents and adolescents completed several self-reported mental health questionnaires, and a demographic information sheet. Potential barriers to care utilization assessed included: (i) discomfort in discussing mental health, (ii) stigmatization, (iii) distrust in effectiveness of mental healthcare, (iv) costs, (v) unavailability of nearby services. Regression models were conducted to examine the correlates of help-seeking for psychiatric disorders. Of the n = 498 youth with a positive screen for a psychiatric disorder, only n = 25 (5.0%) reported ever receiving professional mental healthcare services. Male gender, receiving school accommodation, higher parent-reported hyperactivity and depression were associated with help-seeking after adjustment for other variables. For children with a positive screen who had not sought help, the most often endorsed barriers were costs (22.3% major barrier) and unavailability of nearby services (16.1% major barrier). This study showed that costs and unavailability of nearby services were the biggest barriers to help-seeking among children and adolescents in Lebanon, underscoring the importance of incorporating mental health in public health policies and budget allocation in the East Mediterranean Region.

Young people face challenges in accessing information on HIV and sexual and reproductive health services, with corresponding suboptimal uptake. Decision aids can provide information and decisional support to improve young people's engagement with health interventions. However, they have not been widely implemented among young people. The availability of different choices for HIV and pregnancy prevention means that it is important to implement interventions that facilitate informed choices for these methods. We describe a protocol for a scoping review that aims to explore the availability, acceptability and use of decision aids for HIV prevention and contraception for young people. We will identify relevant studies from the following electronic databases from inception to current date: PubMed, Scopus and Global Health; and grey literature databases, namely medRxiv and Open Access Theses and Dissertations. Eligible studies will report on HIV prevention and/or contraception decision aids and be written in English. Data extraction will be done by two reviewers independently using templates, with discrepancies resolved by consensus. Analysis will be done narratively, and separate for HIV prevention and contraception decision aids. Analysis will also include determination of the suitability of each decision aid for use by young people aged 15-24 years. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews will be employed to present results. This review does not require ethics approval. The findings from this work will be disseminated through peer-reviewed publications and presentations at local and international conferences. This scoping review protocol is registered in Open Science Framework with Project DOI: 10.17605/OSF/IO/46YWG (accessible via: https://doi.org/10.17605/OSF.IO/46YWG).

To explore the experiences of mental health difficulties and access to mental health support among young people with cerebral palsy (CP). We used a qualitative descriptive design. Participants were young people with CP aged 13 to 25 years and parents of children with CP (6-25 years). Nineteen semi-structured interviews were conducted. A narrative thematic analysis was conducted to identify themes related to their mental health experiences. Four themes were identified from the data: (1) understanding manifestations of mental health, triggers, and the importance of early intervention; (2) structural and human challenges in accessing mental health services; (3) the interplay between mental health and personal, social, educational, and familial challenges; (4) navigating future aspirations and holistic mental health support. People with CP face complex, interconnected challenges to their mental health, influenced by personal, family, social, and systemic factors. Mental health difficulties often go unrecognized or are inadequately addressed, highlighting the need for early identification, integrated service provision, and holistic, person-centred interventions that support young people and their families.

We assessed the correlates of willingness to use PrEP among young people (YP) impacted by HIV in Uganda. This cross-sectional study included 905 YP aged 18-21 years, orphaned to AIDS and participating in a longitudinal study in Uganda. Willingness to use PrEP, the primary outcome, was measured using a hypothetical scenario. "If PrEP were safe, effective, free, and used by few people around you, how likely would you be willing to use it?" Independent variables included sociodemographic characteristics, perceived HIV risk, PrEP stigma, barriers to PrEP use, and social support. Multilevel mixed-effects logistic regression was used to examine the relationship between willingness to use PrEP and the independent variables, adjusting for clustering. 74.7% of participants reported willingness to use PrEP. Older age and perceived risk of HIV were associated with a higher likelihood of willingness to use PrEP (aOR = 1.10; 95% CI = 1.01, 1.21 and aOR = 1.65; 95% CI = 1.26, 2.17 respectively). Perceived PrEP stigma was associated with lower willingness (aOR = 0.30; 95% CI = 0.21, 0.42). YP impacted by HIV, show high willingness to use PrEP, influenced by age, risk perception, and stigma.

The rising popularity of vaping among young people constitutes a significant public health concern, underscoring the need to identify factors that contribute to youth initiation and continued engagement in this potentially harmful behaviour. Investigation into the psychological mechanisms underlying vaping among young people remains relatively nascent and has, to date, seldom differentiated between the initial decision to try vaping (i.e., ever-use) and the regulation of sustained patterns of use (i.e., use frequency). We surveyed 451 undergraduate students, collecting data on vaping use, attitudes toward vaping, subjective norms, perceived behavioural control, harm perceptions, and behavioural automaticity. A hurdle modelling approach was used to examine two distinct processes: (1) the correlates of ever-use versus no vaping use, and (2) the frequency of use among individuals with prior vaping experience. Findings supported the application of hurdle modelling, revealing distinct correlates for ever-use and use frequency. Specifically, the former was associated with attitudes, subjective norms, and perceived behavioural control, whereas the latter was associated solely with attitudes and behavioural automaticity. Notably, harm perceptions were not associated with either ever-use or the frequency of use. Findings indicate that both ever-use of a vape and frequency of use are associated with beliefs of the outcomes and experiential experiences of the behaviour, rather than by cognitive evaluations of harm. Although conclusions are limited by the cross-sectional design, current results point to the possibility that the psychological determinants of initial experimentation with vaping may differ from those that sustain use frequency.

ABSTRACT This article addresses the rhetorical dimensions of the language of children and young people around trees and climate change. Via an analysis of statements and stories by children, made in educational settings, the complex constellation of experience, meaning, scientific understanding, mythical imagination and the affective dimensions of fear and hope, that structures children’s environmental awareness, is brought out. In particular, the mythical use to which scientific ideas and terms are put is discussed. In order to foster agency and empowerment with respect to climate futures, environmental education should not only rely on the epistemic regime of scientific thinking but should also adopt a critical rhetorical perspective.

Although retrospective chart-review studies are typically performed using waiver of written informed consent, many institutional review boards (IRB) do not approve such waiver for chart-review studies using prospective enrollment, which could introduce selection bias in participant characteristics and outcomes, thereby impairing representativeness and validity. We aim to determine this bias in a chart-review prostate cancer (PCa) study using prospective enrollment. Using an IRB-approved chart-review protocol with waiver of written informed consent for prospective enrollment, we identified 2,202 patients scheduled for initial prostate biopsy from 2007-2021 at Durham Veterans Affairs Healthcare System. These patients were simultaneously approached for enrollment into a separate minimal-risk prospective observational study protocol requiring blood collection and written consent. 1,238 subjects provided written consent to the blood collection protocol; 964 did not. Patients who provided written consent differed in several key characteristics, including younger age, but had a similar racial distribution. Importantly, participants providing written consent had a significantly lower risk of PCa (multivariable OR=0.41,95%CI=0.31-0.54,p<0.001). As such, patients who provided written consent had younger age, similar race and lower PCa risk and therefore might not accurately represent the full eligible population. To minimize selection bias, waiver of written consent should be allowed for chart-review studies using prospective enrollment.

Background/Objectives: Older adults are vulnerable to inappropriate prescribing and polypharmacy, yet data from the United Arab Emirates are scarce. We estimated the prevalence and correlates of polypharmacy and hyper-polypharmacy among Emirati community-dwelling older adults. Methods: A cross-sectional study of 200 Emiratis aged ≥60 years registered at primary health centers in Ras Al Khaimah used convenience sampling. Data on chronic conditions, medications, and function (Katz Index of Independence in Activities of Daily Living [Katz ADL]; Lawton Instrumental Activities of Daily Living scale [Lawton IADL]) were collected using a structured Arabic questionnaire. Polypharmacy was defined as 5–9 and hyper-polypharmacy as ≥10 medications. Results: Overall, 60% used 5–9 and 40% ≥10 medications; 90% had ≥1 chronic disease and 83% used non-prescribed drugs, commonly analgesics, vitamins, and laxatives. Higher medication burden was associated with poorer ADL and IADL. Younger age and lower Katz ADL scores predicted hyper-polypharmacy. Conclusions: Polypharmacy is highly prevalent and linked to functional limitations, supporting routine medication review, deprescribing, and monitoring of non-prescribed use.

Relevance . The increase in the incidence of drug-resistant tuberculosis necessitates the use of new etiotropic drugs. One of such contemporary drugs is bedaquiline. The literature on the safety and efficacy of bedaquiline in the treatment of tuberculosis in children of early and preschool age is limited. The aim of the study was to assess the tolerability and effectiveness of treatment regimens, including bedaquiline, in children of early and preschool age with active tuberculosis with drugresistant MBT sites. Clinical observation of 7 children of early and preschool age receiving bedaquiline included in the standard chemotherapy regimens for tuberculosis with drug-resistant pathogen sites. Results . Data were obtained on good tolerability and high clinical efficacy of bedaquiline included in standard chemotherapy regimens. Conclusion . It is advisable to continue the clinical use of bedaquiline in children of younger and preschool age.

Abstract. Introduction. The article highlights the problem of forming a stable value and normative framework among citizens in a globalizing world, a virtualized information space, and a transforming social structure. Pedagogy, as a system of methods and means of internalizing state-patriotic values that ensure national security, social stability and unity, plays an important role in the process of educating young people, which determines the relevance of this study. The purpose of the article is to comprehensively analyze state patriotism as a subject of pedagogical research. The methodological foundations of the study include subjective-personal, axiological and comparative-pedagogical approaches, which allow us to reveal the essential characteristics of state patriotism and its differences from other forms of patriotism. Research results. Within the framework of the stated goal, the article presents a detailed analysis of the content and conceptual foundations of state patriotism, identifies its structural components and functional aspects, and proposes strategic directions and practical recommendations for the formation of state-patriotic values in the younger generation. In conclusion, it is concluded that it is necessary to take into account global trends and transformations that affect state patriotism, since in the context of globalization and transformation of the political landscape, it is important to understand how this phenomenon adapts to new challenges and what factors contribute to its strengthening or weakening.

Online gaming is a prevalent leisure activity among young people worldwide. However, limited data exist on the psychological effects of gaming addiction among university students in Oman. This cross-sectional study aimed to estimate the prevalence of gaming addiction risk and explore its relationship with stress, depression, anxiety and self-esteem among university students in Oman. A total of 428 participants completed a self-reported questionnaire encompassing the Game Addiction Scale, Rosenberg Self-Esteem Scale and the Depression, Anxiety and Stress Scale 21. A total of 18.7% (n = 80) of the participants met the polythetic criterion for gaming addiction risk based on the polythetic criterion. Logistic regression revealed that depression, gaming-related financial expenditure, hours spent on gaming, maternal education and academic performance measured by Grade Point Average (GPA) were significantly associated with gaming addiction risk. The model demonstrated good explanatory power, accounting for 47.5% of the variance in gaming addiction (Nagelkerke R2 = 0.475). The results may inform the development of comprehensive prevention strategies that address both psychological and behavioural risk factors. Focused interventions could potentially help mitigate the impact of gaming addiction and may support improved academic and mental health outcomes among university students.

BackgroundCollecting clients experiences of service quality has become routine for mental health services. Young people value the relational aspects of care and the usefulness of treatment, but often encounter mental health services on the initiative of others, suggesting that they may experience low volition about commencing treatment.MethodsUsing a repeated within-subjects design, adolescents' volition in attending sessions was examined in relation to session-climate and usefulness of sessions. Data were collected at the beginning and end of treatment from 66 adolescents attending a social service facility because of mental health problems.ResultsAdolescents reporting high volition at both time points (54%) perceived the session-climate and usefulness of sessions more positively compared to those experiencing low volition at both time points (26%). Adolescents changing from high to low volition experienced a deterioration in the session-climate and did not report an improvement in how useful the sessions were. The source of referral was not related to the volition profiles. Girls were more likely than boys to experience high volition.ConclusionsThe results suggest that key factors of adolescents' service experiences interact with their level of volition. Moreover, the source of referral may not influence the adolescent's willingness to attend sessions.

HIV/sexually transmitted infection (STI) prevention interventions are only modestly successful among youth, particularly for young people of colour and sexual and gender minority (SGM) youth. Even among disparate intervention modalities delivered with high fidelity, differences between intervention types have been minimal. One consistent theme has emerged: the role of the youth:provider relationship in predicting intervention response. In line with calls for examination of relational factors, the next essential step is a harmonised analysis to evaluate connections between the youth:provider relationship and co-occurrence of alcohol and cannabis use, in youth HIV/STI prevention intervention response. Our team has completed six sizeable HIV/STI behavioural prevention studies, generating n=1136 independent youth (baseline Mage=17, range=13-24; 43% female; 21% SGM; 54% Hispanic; 9% African American; 7% Native American/Alaska Native) who received prevention programming and were followed at 1-, 3-, 6-, and/or 12 months. We will harmonise these studies and build a longitudinal mixed-effects machine learning model, with youth:provider relationship as a predictor of intervention response. Participant factors, provider factors and their interaction will be included in the model. Given high rates of alcohol and cannabis comorbidity, we will also examine syndemic outcomes (co-occurring HIV/STI risk behaviours, alcohol use and cannabis use). These data are crucial to informing next step HIV/STI and syndemic intervention programming with this age group. This secondary analysis study is exempt from human subjects regulations under category 4(iii) as determined by the Institutional Review Board at UConn Health. Results will be disseminated via presentations at annual scientific conferences, submissions to peer-reviewed journals, to mental health and substance use providers, as well as community programmes for youth at high risk for HIV/STI and substance use.

The demand for children and adolescent mental health crisis services has risen dramatically in recent years, yet evidence on real-world implementation models remains limited. Rapids is a community-based crisis intervention service developed within Lambeth Children and Adolescent Mental Health Services (CAMHS) at South London and Maudsley NHS Foundation Trust. The primary aim of this study was to examine how clinical presentations, risk profiles, and service outcomes changed over time among children and adolescents accessing Rapids over a 6-year period. We also aimed to describe the characteristics of individuals accessing Rapids. This service evaluation used routinely collected clinical data from all children and adolescents up to 18 years who accessed Rapids between January 1, 2019, and December 31, 2024. Sociodemographic, diagnostic, pharmacological, and risk-related variables were evaluated. Diagnoses were coded using International Classification of Diseases, 10th Revision (ICD-10) criteria. Descriptive and inferential analyses were conducted to assess changes in clinical presentations and service outcomes. In total, 325 children and adolescents were included (mean age = 15.5 years, 61.8% females, 64.6% non-White). Anxiety disorders (29.5%), depressive disorders (42.2%), and autism spectrum disorder (33.5%) were the most common diagnoses. Inpatient admissions increased (1.5%-5.8%, p = 0.043), and high risk to self also rose notably (19.5%-31.7%, p < 0.001). Referrals accepted to adult services decreased significantly over time (38.5%-16.8%, p < 0.001). Diagnostically, eating disorders increased (3.7%-10.0%, p = 0.032), whereas emotionally unstable personality disorder traits decreased (14.1%-7.4%, p = 0.049). Rapids has evolved into an established model of crisis care within CAMHS, addressing acute needs through timely community-based interventions. We observed meaningful temporal changes in the clinical acuity, diagnostic profile, and service use outcomes of young people presenting to our community-based CAMHS crisis service. Our findings support the feasibility and scalability of intensive community-based crisis care and highlight the need for sustained investment in culturally responsive, multidisciplinary service models.

Abstract To assess the clinical characteristics of patients hospitalized with recurrent diabetic ketoacidosis (DKA). We examined the database for patients admitted with recurrent DKA (more than one admission) to government hospitals in Qatar over 6 years and compared them to patients with a single admission. A total of 1,612 patients with DKA were evaluated, of whom 434 patients (26.9%) had recurrent DKA. Compared with patients who had a single admission for DKA, those with recurrent DKA were younger (35.0 [24.0–53.0] vs. 39.0 [28.0–54.0] years, p &lt; 0.001), more likely to be females (50.6 vs. 37.1%, p &lt; 0.001), had a longer duration of diabetes (12.0 [5.0–19.0] vs. 5.0 [0.0–13.0] years, p &lt; 0.001), more likely to have severe DKA (48.6 vs. 38%, p &lt; 0.001), and had shorter time to resolution of DKA (12.5 [9.0–24.0] vs. 23.0 [10.0–33.0] hours, p &lt; 0.001). There was no difference in the precipitating cause of DKA, need for admission to the intensive care unit, hospital stay, or inpatient mortality. On multivariable logistic regression analysis, significant predictors of recurrent DKA were younger age (odds ratio, 0.96; 95% confidence interval [CI]: 0.95–0.98; p = 0.0001), female gender (odds ratio, 0.63; 95% CI: 0.46–0.85; p = 0.003), and longer duration of diabetes (odds ratio, 1.07; 95% CI: 1.04–1.09, p = 0.0001). In this national cohort of patients, recurrent DKA was associated with younger age, female predominance, and longer duration of diabetes, but no difference in duration of hospital stay and inpatient mortality compared with patients with a single admission for DKA.

As of now, NCDs have become a scourge in Kenya as many people die from cancer not diagnosed in good time and at a much younger age; from cardiovascular disease that often goes undiagnosed and type 2 diabetes that becomes difficult to manage. Can we step up our advisory for exercise and diet management? Diet and exercise are two of the most influential lifestyle factors that shape human health across the lifespan. Their effects are deeply interconnected, influencing physical, mental, and emotional well-being. 1. Physical Health Benefits Weight Management: A balanced diet combined with regular physical activity helps prevent obesity and supports healthy weight loss or maintenance. Obesity is a modern health challenge, a stark contrast to my upbringing over six decades ago in western Kenya. Disease Prevention: Healthy eating and exercise reduce the risk of non-communicable diseases such as type 2 diabetes, hypertension, cardiovascular disease, and certain cancers. Longevity: Studies show that individuals who maintain healthy dietary patterns and stay physically active live longer and enjoy a better quality of life. It is not just a question of how long one lives. What is the quality of that longevity? 2. Mental and Emotional Well-being Mood Regulation: Exercise stimulates endorphin release, improving mood and reducing symptoms of anxiety and depression. Depression and stress can be insidious killers, and the best approach is to avoid them. Cognitive Function: Physical activity enhances brain health, improving memory and focus while reducing the risk of cognitive decline. Sleep Quality: Both diet and exercise contribute to better sleep patterns, which in turn support overall health. Poor sleep is a major health risk. 3. Interaction Between Diet and Exercise Synergistic Effects: Nutrition provides the fuel for exercise, while exercise improves metabolism and nutrient utilization. They go hand in hand. Across the Lifespan: From childhood to old age, the combination of healthy eating and regular activity supports growth, development, and healthy aging. 4. Risks of Poor Lifestyle Choices Sedentary Behaviour + Poor Diet: This combination leads to obesity, metabolic syndrome, and increased mortality. Global Concern: Nearly 30% of the world’s population is overweight or obese, highlighting the urgent need for lifestyle interventions. Personal choices are crucial, as not every regimen works for everyone. Expert advice is essential, as there are many myths without a scientific basis. The World Health Organization (WHO) has excellent advice on diet, exercise and non-communicable diseases. Please look it up.

We aimed to investigate the prevalence and risk factors of acute kidney injury (AKI) at juvenile idiopathic arthritis (JIA) onset and its impact on long-term kidney outcomes. In this multicenter study, we retrospectively reviewed 192 children diagnosed with JIA (1998-2025). AKI was defined according to KDIGO serum creatinine criteria. Kidney damage (KD) was defined as chronic kidney disease (CKD) and/or hypertension at follow-up. Logistic and Cox regression analyses were used to identify risk factors and to calculate odds ratio (OR) and hazard ratio (HR), respectively. Kaplan-Meier analysis evaluated KD-free survival. At JIA onset, 45 patients (23.4%) developed AKI, mostly stage 1, with no cases requiring dialysis. Independent predictors of AKI were younger age, elevated C-reactive protein, and ANA positivity. After a mean follow-up of 6.3 years (range 1-27.5), 23 patients (12%) developed KD (19 CKD, 4 hypertension, 2 both). Patients with AKI at onset had a significantly higher risk of KD (OR 5.8, 95% CI: 2.4-15.2; HR 3.7, 95% CI: 1.9-8.9). At 25.1 years of age, the cumulative proportion free from KD was 26.9% in patients with AKI versus 64.1% in those without (p = 0.005). AKI is relatively frequent at JIA onset and represents a strong predictor of long-term kidney damage. Early recognition and careful follow-up of children with AKI may help identify those at greatest risk for adverse kidney outcomes.