Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
Browse
3 results
Search Results
Item Acidosis and Hyperkalemia Caused By Losartan and Enalapril in Pediatric Kidney Transplant Recipients(2014) Sakalli, Hale; Baskin, Esra; Bayrakci, Umut Selda; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0003-4361-8508; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 24447308; B-5785-2018; AAE-1041-2021; AAJ-8097-2021Objectives: To evaluate the efficacy and safety of losartan and enalapril in pediatric kidney transplant recipients. Materials and Methods: A retrospective review was performed in 31 pediatric kidney transplant recipients who were treated with losartan (50 mg/d, oral) for 1 to 6 months because of mild hypertension and persistent proteinuria. All patients were treated concurrently with enalapril (5 or 10 mg daily, oral), and 12 patients (39%) also were treated with amlodipine (5 or 10 mg daily, oral). Demographic and clinical characteristics of the patients were reviewed. Results: Losartan use was associated with a significant decrease in mean systolic (before losartan was started, 123 +/- 14 mm Hg; before losartan was stopped, 111 +/- 10 mm Hg; P <= .001) and diastolic blood pressure (before losartan was started, 78 +/- 11 mm Hg; before losartan was stopped, 69 +/- 10 mm Hg; P <= .001) and urinary protein excretion (before losartan was started, 51 +/- 45 mg/m(2)/h; before losartan was stopped, 28 +/- 34 mg/m(2)/h; P <= .001). However, losartan therapy was associated with a significant mean increase in serum potassium level (before losartan was started, 4.0 +/- 0.4 mmol/L; before losartan was stopped, 5.7 +/- 0.5 mmol/L; P <= .001) and decrease in pH (before losartan was started, 7.35 +/- 0.0; before losartan was stopped, 7.23 +/- 0.0; P <= .001). Losartan was stopped because of hyperkalemia and acidosis earlier in patients who were on tacrolimus than cyclosporine immunosuppression (tacrolimus, 3 +/- 1 mo; cyclosporine, 4.7 +/- 0.8 mo; P <= .001). Conclusions: Losartan and enalapril may be beneficial in pediatric kidney transplant recipients by decreasing blood pressure and proteinuria, with maintenance of stable graft function, but may be associated with serious adverse events including hyperkalemia and life-threatening acidosis.Item Association Of Pediatric Vasculitis Activity Score With Immunoglobulin A Vasculitis With Nephritis(2023) Avci, Begum; Kurt, Tuba; Aydin, Fatma; Celikel, Elif; Tekin, Zahide Ekinci; Sezer, Muge; Tekgoz, Nilufer; Karagol, Cuneyt; Coskun, Serkan; Kaplan, Melike Mehves; Bayrakci, Umut Selda; Acar, Banu; https://orcid.org/0000-0002-5375-379X; 35895124Background Immunoglobulin A vasculitis with nephritis (IgAVN) is the most serious complication affecting long-term prognosis. Understanding the risk factors and markers for the development of IgAVN is essential. The aim of this study is to identify IgAVN-associated factors and to evaluate the usability of Pediatric Vasculitis Activity Score (PVAS) at diagnosis as an early marker for the development of IgAVN. Methods We conducted a retrospective case-control study of 314 patients divided into two groups: those with nephritis (IgAVN) and without nephritis (non-IgAVN). The groups were compared in terms of clinical symptoms, laboratory values, and PVAS values. Results In total, 18.5% of the patients had IgAVN; they were older than the non-IgAVN patients (median age was 8.8, p < 0.05). Arthritis/arthralgia, abdominal pain, and intestinal bleeding were more common, systolic and diastolic BP were higher in IgAVN (p < 0.05). CRP, serum creatinine, and urine protein/Cr, PVAS were higher, while serum albumin was lower in IgAVN (p < 0.05). The receiver operator characteristic curve (ROC) analysis showed that IgAV patients with a determined cut-off PVAS value greater than 3 had 70.7% sensitivity in predicting whether or not they would develop IgAVN. Logistic regression analysis found that PVAS > 3 and low serum albumin at the time of diagnosis were independent risk factors for IgAVN. Conclusion Our study revealed that PVAS > 3 at diagnosis is an independent predictor of IgAVN. Patients with PVAS > 3 should be followed more closely to ensure early diagnosis and management of IgAVN.Item 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.; 000829126000001Background 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.