Wos İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Kidney Transplantation in Small Children: Association Between Body Weight and Outcome-A Report From the ESPN/ERA-EDTA Registry(2022) Boehm, Michael; Bonthuis, Marjolein; Aufricht, Christoph; Battelino, Nina; Bjerre, Anna; Edvardsson, Vidar O.; Herthelius, Maria; Hubmann, Holger; Jahnukainen, Timo; de Jong, Huib; Laube, Guido F.; Mattozzi, Francesca; Molchanova, Elena A.; Munoz, Marina; Noyan, Aytul; Pape, Lars; Printza, Nikoleta; Reusz, George; Roussey, Gwenaelle; Rubik, Jacek; Spasojevic-Dimitrijeva, Brankica; Seeman, Tomas; Ware, Nicholas; Vidal, Enrico; Harambat, Jerome; Jager, Kitty J.; Groothoff, Jaap; 33795596Background. Many centers accept a minimum body weight of 10 kg as threshold for kidney transplantation (Tx) in children. As solid evidence for clinical outcomes in multinational studies is lacking, we evaluated practices and outcomes in European children weighing below 10 kg at Tx. Methods. Data were obtained from the European Society of Paediatric Nephrology/European Renal Association and European Dialysis and Transplant Association Registry on all children who started kidney replacement therapy at <2.5 y of age and received a Tx between 2000 and 2016. Weight at Tx was categorized (<10 versus >= 10 kg) and Cox regression analysis was used to evaluate its association with graft survival. Results. One hundred of the 601 children received a Tx below a weight of 10 kg during the study period. Primary renal disease groups were equal, but Tx <10 kg patients had lower pre-Tx weight gain per year (0.2 versus 2.1 kg; P < 0.001) and had a higher preemptive Tx rate (23% versus 7%; P < 0.001). No differences were found for posttransplant estimated glomerular filtration rates trajectories (P = 0.23). The graft failure risk was higher in Tx <10 kg patients at 1 y (graft survival: 90% versus 95%; hazard ratio, 3.84; 95% confidence interval, 1.24-11.84), but not at 5 y (hazard ratio, 1.71; 95% confidence interval, 0.68-4.30). Conclusions. Despite a lower 1-y graft survival rate, graft function, and survival at 5 y were identical in Tx <10 kg patients when compared with Tx >= 10 kg patients. Our results suggest that early transplantation should be offered to a carefully selected group of patients weighing <10 kg.Item The relationship between body mass index and renal length in obese children(2020) Parmaksiz, Gonul; Kekec, Senay Demir; Cengiz, Nurcan Dinler; Noyan, Aytul; 0000-0003-2373-1837; 31997076; AAD-5713-2021; AAM-2935-2021Background Obesity in the pediatric population is a severe public health problem and is associated with various comorbidities. Renal length is an important clinical parameter for the diagnosis and follow-up of renal diseases. The aim of this study was to determine the relationship between renal length (measured ultrasonographically) and body mass index (BMI) in obese children, and to develop nomograms for renal length according to BMI. Methods Renal ultrasound was performed in 368 children without renal disease. Each child's age, gender, weight, height, and BMI (kg/m(2)) were recorded. The children were divided into three groups according to BMI percentiles: obese group: BMI >= 95th percentile; overweight group: BMI 85th-94th percentile; normal weight group: BMI 5th-84th percentile. Results Weight, height, BMI, and right and left renal length differed significantly between the three groups (p = 0.001). There were significant correlations between renal length with age, weight, height, and BMI. Measurement of renal length was independently associated with BMI, age, and height. BMI was used to create renal length nomograms for obese children, based on multiple regression analysis (R-2 = 0.32 and p = 0.0001). Mean renal length was highest in the obese group (96.9 +/- 13.4 mm) and lowest in the normal weight group (88.3 +/- 12.9 mm). Conclusions Ultrasonographic measurement of the renal length according to BMI in children can be a useful method in evaluating these children. Smaller-than-normal kidneys can easily remain undiagnosed in obese and overweight children and this nomogram offers an additional method to evaluate the renal size in obese children.Item 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-5713-2021Background 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.Item The effect of Ca-Dobesilate over renal scar formation in an experimental pyelonephritis model(2020) Simsek, Behcet; Beyazit, Aysun Karabay; Gonlusen, Gulfiliz; Noyan, Aytul; Anarat, AliPurpose: This study was conducted to evaluate the effects of the drug: Ca-Dobesilate (CaD) which has been in common use in venous insufficiency treatment; on renal scarring and expressions of transforming growth factor beta1 (TGFb1), basic fibroblast growth factor (bFGF) and hepatocyte growth factor-beta (HGF-beta) in a rat pyelonephritis model. Materialw and Methods: Eight pyelonephritis groups, each constituting of 7 rats were developed as no treatment ciprofloxacin - ciprofloxacin and CaD administered groups; following injecting E Coli (ATCC 25922) into kidney. No treatment given rat groups were sacrificed following 24h, 72 h, 14d and 28d from bacterial seeding respectively. Rats from treatment groups were sacrificed after 14d and 28d accordingly. Diagnoses of pyelonephritis and fibrosis, TGFb, bFGF and HGF-beta were scored semiquantitatively by immunohistochemical staining. Results: The extent of pyelonephritis and fibrosis was lower in rats treated with ciprofloxacin and CaD compared to sole ciprofloxacin and no treatment administered counterparts among groups terminated after 2wks following bacterial inoculation. However, CaD effect on pyelonephritis and fibrosis scores did not persist after treatment was discontinued. Conclusion: CaD might alleviate pyelonephritis and scarring, depending on dosage and treatment period and further studies are needed to determine optimum treatment dose and duration.Item Intractable Diarrhea from Cytomegalovirus Colitis in a Case with Hereditary Spherocytosis(2015) Ozkale, Murat; Canan, Oguz; Asilsoy, Suna; Bal, Nebil; Noyan, AytulCytomegalovirus (CMV) infection is a common viral infection worldwide, with a frequency as high as 90% in developing countries. Only 10% of primary CMV infection is symptomatic in immunocompetent patients, and it rarely causes specific complications. We report CMV colitis in an immunocompetent adolescent with hereditary spherocytosis and spontaneous rupture of the spleen, who was critically ill with septicaemia and significant non-bloody diarrhoea that responded to specific CMV treatment.Item Can We Differentiate Pyelonephritis and Cystitis without 99mTc-Dimercaptosuccinic Acid Scan in Children?(2015) Kilicaslan, Buket; Noyan, Aytul; Cengiz, Nurcan; Sariturk, Cagla; Parmaksiz, Gonul; Baskin, EsraPurpose: Urinary tract infection is one of the most common infections in childhood. Because of the long term sequelae, differentiation of pyelonephritis from cystitis is important. The aim of this study is to determine the value of biomarkers such as C-reactive protein and procalcitonin and whether preferred to predict pyelonephritis in children without 99mTc-Dimercaptosuccinic Acid scan. Material and Methods: Fifty children aged 3 months to 16 years with a first urinary tract infection were included in this retrospective observational study. The medians, sensitivity, specificity, and cut-off values of serum C - reactive protein and procalcitonin to predict pyelonephritis were determined. Results: Thirty-two (64%) patients were diagnosed with pyelonephritis and 18 (36%) were diagnosed with cystitis. The cut-off value for C - reactive protein was 34 mg/L to predict pyelonephritis, with 69% sensitivity and 61% specificity. The cut-off value for procalcitonin was 0.23 ng/mL to predict pyehlonephritis, with 69% sensitivity and 66% specificity. In combination, these biomarkers were 63% sensitive and 78% specific to predict pyelonephritis. Conclusion: Using a combination of procalcitonin and C-Reactive Protein is preferred to predict pyelonephritis in children, instead of the 99mTc-Dimercaptosuccinic Acid scan. Because of its disadvantages, the 99mTc-Dimercaptosuccinic Acid scan should be avoided in children.Item Cardiac effects of hemodialysis in children with chronic kidney disease(2018) Noyan, Aytul; Arslan, Alev; Kucukosmanoglu, Osman; Ozbarlas, NazanPurpose: The aim of the study was to evaluate cardiac functions before and after hemodialysis in children with chronical renal failure. Materials and Methods: The study comprised 24 children undergoing hemodialysis more then six months. Conventional and tissue Doppler echocardiography was performed, NT-proBNP levels were measured before and after hemodialysis. Echocardiographic results were compared regard to hydration status which measured with body composition monitor and hypotension event during dialysis. Results: Myocardial performance indices which gained with tissue Doppler echo were high in 22 patient. Mitral E/A ratio significantly decreased after hemodialysis. NT-proBNP levels were high but no difference was determined after dialysis. Nine patient experienced hypotension but nonsignificant difference was detected regarding echocardiographic findings and NT-proBNP levels. Conclusion: Diastolic dysfunction is frequent in chronical renal failure. Tissue Doppler echocardiography and myocardial performance index supply a more proper evaluation of global and regional cardiac function in chronical renal failure due to less hydration affectability. NT-proBNP should be monitored for cardiac dysfunction in chronical renal failure. Body composition monitor should be used in children for setting the ultrafiltration volume.