Browsing by Author "Bakkaloglu, Sevcan A."

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The Effect of Dialysis Initiation Timing on Left Ventricular Hypertrophy and Inflammation in Pediatric Patients
(2015) Bakkaloglu, Sevcan A.; Kandur, Yasar; Serdaroglu, Erkin; Noyan, Aytul; Bayazit, Aysun Karabay; Sever, Lale; Ozlu, Sare G.; Ozcelik, Gul S.; Dursun, Ismail; Yavascan, Onder; AAD-5713-2021
Effect of The Timing of Dialysis Initiation on Left Ventricular Hypertrophy and Inflammation in Pediatric Patients
(2017) Bakkaloglu, Sevcan A.; Kandur, Yasar; Serdaroglu, Erkin; Noyan, Aytul; Bayazit, Aysun Karabay; Sever, Lale; Ozlu, Sare Gulfem; Ozcelik, Gul; Dursun, Ismail; Alparslan, Caner; 2-s2.0-85017214984; AAD-5713-2021
Background The optimal time for dialysis initiation in adults and children with chronic kidney disease remains unclear. The aim of this study was to evaluate the impact of dialysis timing on different outcome parameters, in particular left ventricular (LV) morphology and inflammation, in pediatric patients receiving peritoneal dialysis and hemodialysis. Methods The medical records of pediatric dialysis patients who were followed-up in nine pediatric nephrology centers in Turkey between 2008 and 2013 were retrospectively reviewed. In addition to demographic data, we retrieved anthropometric measurements, data on dialysis treatment modalities, routine biochemical parameters, complete blood count, serum ferritin, parathormone, C-reactive protein (CRP), and albumin levels, as well as echocardiographic data and hospitalization records. The patients were divided into two groups based on their estimated glomerular filtration rate (eGFR) levels at dialysis initiation, namely, an early-start group, characterized by an eGFR of > 10 ml/min/1.73 m(2), and a late-start group, with an eGFR of < 7 ml/min/1.73 m(2). The collected data were compared between these groups. Results A total of 245 pediatric dialysis patients (mean age +/- standard deviation 12.3 +/- 5.1 years, range 0.5-21 years) were enrolled in this study. Echocardiographic data were available for 137 patients, and the mean LV mass index (LVMI) was 58 +/- 31 (range 21-215) g/m(2.7). The LVMI was 75 +/- 30 g/ m(2.7)(n = 81) and 34 +/- 6 g/m(2.7)(n = 56) in patients with or without LV hypertrophy (LVH) (p < 0.001). Early-start (eGFR > 10 ml/min/1.73 m(2)) versus late-start dialysis (eGFR < 7 ml/ min/1.73 m(2)) groups did not significantly differ in LVMI and LVH status (p > 0.05) nor in number of hospitalizations. Serum albumin levels were significantly higher in the earlydialysis group compared with the late-dialysis group (3.3 +/- 0.7 vs. 3.1 +/- 0.7 g/dl, respectively; p < 0.05). The early-start group had relatively higher time-averaged albumin levels (3.2 +/- 0.5 vs. 3.1 +/- 0.5 g/dl; p = > 0.05) and relatively lower CRP levels (3.64 +/- 2.00 vs. 4.37 +/- 3.28 mg/L, p > 0.05) than the late-start group, but these differences did not reach statistical significance. Conclusion Although early dialysis initiation did not have a significant effect on important clinical outcome parameters, including LVH, inflammatory state, and hospitalization, in our pediatric dialysis patients, this area of study deserves further attention.
Evaluation of non-infectious complications of peritoneal dialysis in children: a multicenter study
(2020) Aksoy, Gulsah Kaya; Ekim, Mesiha; Bakkaloglu, Sevcan A.; Coskun, Seda; Delibas, Ali; Conkar, Secil; Yilmaz, Dilek; Kara, Aslihan; Saygili, Seha K.; Buyukkaragoz, Bahar; Yildirim, Zeynep Y.; Comak, Elif; Gurgoze, Metin K.; Sever, Lale; Noyan, Aytul; Bayazit, Aysun K.; Dusunsel, Ruhan; 32728843; AAD-5713-2021
Background Peritoneal dialysis (PD) is the most common kidney replacement therapy in children. Complications associated with PD affect treatment success and sustainability. The aim of this study was to investigate the frequency of PD-related noninfectious complications and the predisposing factors. Methods Retrospective data from 11 centers in Turkey between 1998 and 2018 was collected. Non-infectious complications of peritoneal dialysis (NICPD), except metabolic ones, in pediatric patients with regular follow-up of at least 3 months were evaluated. Results A total of 275 patients were included. The median age at onset of PD and median duration of PD were 9.1 (IQR, 2.5-13.2) and 7.6 (IQR, 2.8-11.9) years, respectively. A total of 159 (57.8%) patients encountered 302 NICPD within the observation period of 862 patient-years. The most common NIPCD was catheter dysfunction (n = 71, 23.5%). At least one catheter revision was performed in 77 patients (28.0%). Longer PD duration and presence of swan neck tunnel were associated with the development of NICPD (OR 1.191; 95% CI 1.079-1.315, p = 0.001 and OR 1.580; 95% CI 0.660-0.883, p = 0.048, respectively). Peritoneal dialysis was discontinued in 145 patients; 46 of whom (16.7%) switched to hemodialysis. The frequency of patients who were transferred to hemodialysis due to NICPD was 15.2%. Conclusions Peritoneal dialysis-related non-infectious complications may lead to discontinuation of therapy. Presence of swan neck tunnel and long duration of PD increased the rate of NICPD. Careful monitoring of patients is necessary to ensure that PD treatment can be maintained safely.
Evaluation Of Patients With Primary Hyperoxaluria Type 1: A Multicenter Study
(2018) Bakkaloglu, Sevcan A.; Buyykkaragoz, Bahar; Saygili, Seha; Comak, Elif; Yildirim, Zeynep Y.; Akinci, Nurver; Bayazit, Aysun Karabay; Tufan, Asli Kavaz; Akman, Sema; Yilmaz, Alev; Dursun, Ismail; Noyan, Aytul; Agbas, Ayse; Serdaroglu, Erkin; Delibas, Ali; Elmaci, Ahmet Midhat; Tasdemir, Mehmet; Sever, Lale; AAD-5713-2021
Impact of Hemoglobin Variability on Outcome Parameters in Pediatric Dialysis Patients
(2017) Bakkaloglu, Sevcan A.; Kandur, Yasar; Serdaroglu, Erkin; Noyan, Aytul; Bayazit, Aysun Karabay; Sever, Lale; Ozlu, Sare G.; Ozcelik, Gul; Dursun, Ismail; Alparslan, Caner; AAD-5713-2021
Time-Averaged Hemoglobin Values, Not Hemoglobin Cycling, Have an Impact On Outcomes in Pediatric Dialysis Patients
(2018) Bakkaloglu, Sevcan A.; Kandur, Yasar; Serdaroglu, Erkin; Noyan, Aytul; Bayazit, Aysun Karabay; Tasdemir, Mehmet; Ozlu, Sare Gulfem; Ozcelik, Gul; Dursun, Ismail; Alparslan, Caner; Akcaboy, Meltem; Atikel, Yesim Ozdemir; Parmaksiz, Gonul; Atmis, Bahriye; Sever, Lale; 30105415; AAD-5713-2021
During erythropoietin-stimulating agent (ESA) treatment, hemoglobin (Hb) levels usually fluctuate; this phenomenon is known as "Hb cycling (HC)." In this study, we aimed to evaluate the predictors of HC and its impact on left ventricular hypertrophy (LVH) as a patient-important outcome parameter in pediatric dialysis patients. Records of patients followed up in nine pediatric nephrology centers between 2008 and 2013 were reviewed. More than 1 g/dL decrease or increase in Hb level was considered as HC. Patients were divided into two groups according to 12-month Hb trajectory as rare cycling (RC) (<= 3) and frequent cycling (FC) (> 3 fluctuation) as well as three groups based on T-A-Hb levels: < 10, 10-11, and > 11 g/dL. Two hundred forty-five dialysis (160 peritoneal dialysis (PD) and 85 hemodialysis (HD)) patients aged 12.3 +/- 5.1 (range 0.5-21) years were enrolled in this study. Fifty-two percent of the patients had RC, 45% had FC, and only 3% had no cycling. There were no differences between HC groups with respect to age, dialysis modality, having anemia, hospitalization rate, residual urine volume, and mortality. Although left ventricular mass index (LVMI) tended to be higher in RC than FC group (65 +/- 37 vs 52 +/- 23 g/m(2.7), p = 0.056), prevalence of LVH was not different between the groups (p = 0.920). In regression analysis, FC was not a risk factor for LVH, but low T-A Hb level (< 10 g/dL) was a significant risk for LVH (OR = 0.414, 95% CI 0.177-0.966, p = 0.04). The target Hb levels were more often achieved in PD patients, and the number of deaths was significantly lower in non-anemic patients (Hb level > 11 g/dL). Hb cycling is common among dialysis patients. Severity of anemia rather than its cycling has more significant impact on the prevalence of LVH and on inflammatory state.
Utility Of Continuous Performance Test (MOXO-CPT) In Children With Pre-Dialysis Chronic Kidney Disease, Dialysis And Kidney Transplantation
(2022) Buyukkaragoz, Bahar; Soysal Acar, A. Sebnem; Ekim, Mesiha; Bayrakci, Umut Selda; Bulbul, Mehmet; Caltik Yilmaz, Aysun; Bakkaloglu, Sevcan A.; 000829126000001
Background Children with chronic kidney disease and on kidney replacement therapy may have neurocognitive and psychosocial disorders. Although kidney transplantation improves quality of life, psychological problems may exist in children who undergo kidney transplantation. Herein, we aimed to investigate attention-deficit hyperactivity disorder-like symptoms with MOXO-continuous performance test in children with pre-dialysis chronic kidney disease, dialysis and kidney transplantation. Methods The MOXO-continuous performance test measures four domains of attention-deficit hyperactivity disorder-like symptoms, including attention, timeliness, hyperactivity and impulsivity. Patients with at least three scores < - 1.5 standard deviations were considered as positive to MOXO-continuous performance test. Test scores of the pre-dialysis chronic kidney disease, dialysis (divided into peritoneal dialysis and hemodialysis subgroups) and kidney transplantation groups were compared. Correlations of test scores with the patient's clinical and laboratory characteristics and effects of hospitalizations and schooling were assessed. Results Seventy-two patients aged 13.3 +/- 3.4 years (23 with kidney transplantation, 23 on dialysis and 26 with pre-dialysis chronic kidney disease) were evaluated. Overall MOXO-continuous performance test positivity was 29%. No differences were detected between the three groups concerning total or z scores. Attention and timeliness z scores were significantly higher in females (p = 0.004 and p = 0 .008 , respectively). Age was positively correlated to attention and timeliness total scores (p = 0.000, r = 0.445 and p = 0.004, r = 0.243, respectively), and inversely correlated to hyperactivity total scores (p = 0.000, r = - 0.415). Conclusions Prevalence of attention-deficit hyperactivity disorder-like symptoms in the study population was much higher than that of pediatric attention-deficit hyperactivity disorder. We believe that the MOXO-continuous performance test is a valid supportive measure for evaluation of attention-deficit hyperactivity disorder diagnosis in children with various stages of chronic kidney disease or on kidney replacement therapy.