MCBÜ Açıkerişim Sistemi :: Browsing by Author "Aksu B."

Browsing by Author "Aksu B."

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A nationwide retrospective study in Turkish children with nephrocalcinosis
(NLM (Medline), 2021) Döven S.S.; Tülpar S.; Baştuğ F.; Yıldırım Z.N.Y.; Yılmaz E.K.; Çiçek N.; Küçük N.; Çomak E.; Yazıcıoğlu B.; Nalçacıoğlu H.; Delibaş A.; Uysal B.; Ağbaş A.; Gemici A.; Günay N.; Ertan P.; Bıyıklı N.; Hacıhamdioğlu D.Ö.; Elmacı A.M.; Atikel Y.Ö.; Delebe E.ÖÇ.; Sever F.L.; Gökçe İ.; Öner N.; Akman S.; Aksu B.; Atmış B.; Yel S.; Yılmaz A.; Çelik B.; Dursun İ.; Alpay H.
BACKGROUND: Nephrocalcinosis (NC) is defined as calcium deposition in the kidney parenchyma and tubules. This study aims to determine the etiology, risk factors, and follow-up results of patients with NC in Turkey. METHODS: Patients diagnosed with NC in the pediatric nephrology Department Units of 19 centers from all geographical regions of Turkey over a 10-year period (2010-2019) were included in the study. The medical records from the centers were reviewed and demographic data, admission complaints, medical history, systemic and genetic disorders, risk factors for NC, treatment details, and presence of NC after one-year follow-up, were recorded retrospectively. RESULTS: The study sample included 195 patients (88 females, 107 males). The mean age at diagnosis was 39.44 ± 47.25 (0.5-208) months; 82/190 patients (43.2%) were diagnosed incidentally; 46/195 patients (23.6%) had an underlying disease; idiopathic hypercalciuria was detected in 75/195 (38.4%) patients. The most common systemic diseases were distal renal tubular acidosis in 11/46 patients (23.9%), primary hyperoxaluria in 9/46 patients (19.6%) and Bartter syndrome in 7/46 patients (15.3%). After one year of follow-up, NC resolved in 56/159 patients (35.2%) and they all did not have an underlying systemic disease. DISCUSSION: The most common presentation of NC was incidental. Distal renal tubular acidosis and primary hyperoxaluria were the main systemic diseases leading to NC, while hypercalciuria was the most common metabolic risk factor. Nephrocalcinosis was found to remain in most of the patients at a one-year follow-up. It may resolve particularly in patients with no underlying systemic disease.
Comparison of infants and children with urolithiasis: a large case series
(Springer Science and Business Media Deutschland GmbH, 2022) Baştuğ F.; Ağbaş A.; Tülpar S.; Yıldırım Z.N.Y.; Çiçek N.; Günay N.; Gemici A.; Çelik B.; Delebe E.Ö.Ç.; Nalçacıoğlu H.; Yılmaz A.; Gökçe İ.; Demircin G.; Hacıhamdioğlu D.Ö.; Yılmaz K.; Atmış B.; Yılmaz E.K.; Ertan P.; Dursun İ.; Aksu B.; Akbulut B.B.; Döven S.S.; Öner N.; Yel S.; Elmacı A.M.; Atikel Y.Ö.; Erfidan G.; Uysal B.; Bıyıklı N.; Yazıcıoğlu B.; Küçük N.; Çomak E.; Sever F.L.; Akil İ.; Aksoy Ö.; Alpay H.
We evaluated the demographic features, etiologic risk factors, treatment strategies, and outcome of the infants and children with urolithiasis (UL). A retrospective multicenter study was conducted including 23 Pediatric Nephrology centers in Turkey. The medical records of 2513 children with UL were reviewed. One thousand, three hundred and four boys and 1209 girls (1.1:1) were reported. The mean age at diagnosis was 39.5 ± 35 months (0.4–231 months), and 1262 patients (50.2%) were in the first year of life (infants). Most of the cases with infantile UL were diagnosed incidentally. Microlithiasis (< 3 mm) was found in 794 patients (31.6%), and 64.5% of the patients with microlithiasis were infants. Stones were located in the pelvis-calyces in 63.2% (n: 1530) of the cases. The most common stone type was calcium oxalate (64.6%). Hypocitraturia was the most common metabolic risk factor (MRF) in children older than 12 months, but in infancy, hypercalciuria was more common. Fifty-five percent of the patients had received at least one medical treatment, mostly potassium citrate. At the end of a year’s follow-up, most of the patients with microlithiasis (85%) showed spontaneous remission. The rate of spontaneous stone resolution in infants was higher than in children. Spontaneous remission rate was higher in cases with MRF (− ) stones than in MRF (+) stones. However, remission rate with medical treatment was higher in cases with MRF (+) stones. This study represents the results of a large series of infants and children with UL and showed that there are several differences such as underlying metabolic and anatomic abnormalities, clinical course, and stone remission rates between infants and children with urinary stone disease. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Kidney disease profile and encountered problems during follow-up in Syrian refugee children: a multicenter retrospective study
(Springer Science and Business Media Deutschland GmbH, 2022) Balat A.; Kilic B.D.; Aksu B.; Kara M.A.; Buyukcelik M.; Agbas A.; Eroglu F.K.; Gungor T.; Alaygut D.; Yildiz N.; Bastug F.; Atmis B.; Melek E.; Elmaci M.; Tulpar S.; Pehlivanoglu C.; Doven S.S.; Comak E.; Tabel Y.; Gemici A.; Uysal B.; Ozzorlar G.S.; Kuçuk N.; Delibas A.; Ozcelik G.; Goknar N.; Dursun I.; Ertan P.; Ozunan I.A.; Sonmez F.
Background: Children are one of the most vulnerable groups in conflict zones, especially those with chronic diseases. This study aimed to investigate kidney disease profiles and problems during follow-up in a population of Syrian refugee children residing in Turkey. Methods: Syrian refugee children aged between 0 and 18 years were included in the study. Demographic data, diagnosis, particular interventions due to nephrological problems, and problems encountered during follow-up were obtained from all participating pediatric nephrology centers. Results: Data from 633 children from 22 pediatric nephrology centers were included. Mean age of the children was 94.8 ± 61.7 months and 375 were male (59%). 57.7% had parental consanguinity and 23.3% had a close relative(s) with kidney disease. The most common kidney diseases were congenital anomalies of the kidney and urinary tract (CAKUT) (31.0%), glomerular disease (19.9%), chronic kidney disease (CKD) (14.8%), and urolithiasis (10.7%). Frequent reasons for CAKUT were nonobstructive hydronephrosis (23.0%), vesico-ureteral reflux (18.4%), and neurogenic bladder (15.8%). The most common etiology of glomerular diseases was nephrotic syndrome (69%). Ninety-four children had CKD, and 58 children were on chronic dialysis. Six children had kidney transplantation. Surgical intervention was performed on 111 patients. The language barrier, lack of medical records, and frequent disruptions in periodic follow-ups were the main problems noted. Conclusions: CAKUT, glomerular disease, and CKD were highly prevalent in Syrian refugee children. Knowing the frequency of chronic diseases and the problems encountered in refugees would facilitate better treatment options and preventive measures. © 2021, IPNA.
Urinary HSP70 improves diagnostic accuracy for urinary tract infection in children: UTILISE study
(Springer Science and Business Media Deutschland GmbH, 2023) Yilmaz A.; Afonso A.C.; Akil I.; Aksu B.; Alpay H.; Atmis B.; Aydog O.; Bayazıt A.K.; Bayram M.T.; Bilge I.; Bulut I.K.; Buyukkaragoz B.; Comak E.; Demir B.K.; Dincel N.; Donmez O.; Durmus M.A.; Dursun H.; Dusunsel R.; Duzova A.; Ertan P.; Gedikbasi A.; Goknar N.; Guven S.; Hacihamdioglu D.; Jankauskiene A.; Kalyoncu M.; Kavukcu S.; Kenan B.U.; Kucuk N.; Kural B.; Litwin M.; Montini G.; Morello W.; Nayir A.; Obrycki L.; Omer B.; Ozdemir E.M.; Ozkayin N.; Paripovic D.; Pehlivanoglu C.; Saygili S.; Schaefer S.; Sonmez F.; Tabel Y.; Tas N.; Tasdemir M.; Teixeira A.; Tekcan D.; Tulpar S.; Turkkan O.N.; Uysal B.; Uysalol M.; Vaiciuniene D.; Yavuz S.; Yel S.; Yildirim T.; Yildirim Z.Y.; Yildiz N.; Yuksel S.; Yurtseven E.; Schaefer F.; Topaloglu R.
Background: The accuracy of conventional urinalysis in diagnosing urinary tract infection (UTI) in children is limited, leading to unnecessary antibiotic exposure in a large fraction of patients. Urinary heat shock protein 70 (uHSP70) is a novel marker of acute urinary tract inflammation. We explored the added value of uHSP70 in discriminating UTI from other infections and conditions confused with UTI. Methods: A total of 802 children from 37 pediatric centers in seven countries participated in the study. Patients diagnosed with UTI (n = 191), non-UTI infections (n = 178), contaminated urine samples (n = 50), asymptomatic bacteriuria (n = 26), and healthy controls (n = 75) were enrolled. Urine and serum levels of HSP70 were measured at presentation in all patients and after resolution of the infection in patients with confirmed UTI. Results: Urinary (u)HSP70 was selectively elevated in children with UTI as compared to all other conditions (p < 0.0001). uHSP70 predicted UTI with 89% sensitivity and 82% specificity (AUC = 0.934). Among the 265 patients with suspected UTI, the uHSP70 > 48 ng/mL criterion identified the 172 children with subsequently confirmed UTI with 90% sensitivity and 82% specificity (AUC = 0.862), exceeding the individual diagnostic accuracy of leukocyturia, nitrite, and leukocyte esterase positivity. uHSP70 had completely normalized by the end of antibiotic therapy in the UTI patients. Serum HSP70 was not predictive. Conclusions: Urine HSP70 is a novel non-invasive marker of UTI that improves the diagnostic accuracy of conventional urinalysis. We estimate that rapid urine HSP70 screening could spare empiric antibiotic administration in up to 80% of children with suspected UTI. Graphical abstract: A higher resolution version of the Graphical abstract is available as Supplementary information [Figure not available: see fulltext.] © 2022, The Author(s), under exclusive licence to International Pediatric Nephrology Association.
The relationship between urine heat shock protein 70 and congenital anomalies of the kidney and urinary tract: UTILISE study
(Frontiers Media SA, 2023) Aksu B.; Afonso A.C.; Akil I.; Alpay H.; Atmis B.; Aydog O.; Bakkaloglu S.; Bayazıt A.K.; Bayram M.T.; Bilge I.; Bulut I.K.; Cetinkaya A.P.G.; Comak E.; Demir B.K.; Dincel N.; Donmez O.; Durmus M.A.; Dursun H.; Dusunsel R.; Duzova A.; Ertan P.; Gedikbasi A.; Goknar N.; Guven S.; Hacihamdioglu D.; Jankauskiene A.; Kalyoncu M.; Kavukcu S.; Kenan B.U.; Kucuk N.; Kural B.; Litwin M.; Montini G.; Morello W.; Obrycki L.; Omer B.; Misirli Ozdemir E.; Ozkayin N.; Paripovic D.; Pehlivanoglu C.; Saygili S.; Schaefer F.; Schaefer S.; Sonmez F.; Tabel Y.; Tas N.; Tasdemir M.; Teixeira A.; Tekcan D.; Topaloglu R.; Tulpar S.; Turkkan O.N.; Uysal B.; Uysalol M.; Vitkevic R.; Yavuz S.; Yel S.; Yildirim T.; Yildirim Z.Y.; Yildiz N.; Yuksel S.; Yurtseven E.; Yilmaz A.
Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are defined as structural malformations of the kidney and/or urinary tract. Heat shock proteins (HSPs) are expressed in the kidney in response to cellular changes, such as thermal, hemodynamic, osmotic, inflammatory, and mechanical stresses. This study aimed to assess uHSP70 levels during acute urinary tract infections (UTI) and non-infection periods in patients with CAKUT, and to evaluate whether uHSP70 is elevated in CAKUT subtypes. Methods: Among patients with CAKUT, 89 patients with UTI (CAKUT-A), 111 without UTI (CAKUT-B), and 74 healthy children were included in the study. uHSP70 levels were measured using enzyme-linked immunosorbent assay (ELISA). Results: uHSP70 level was significantly higher in the CAKUT-A group than in the CAKUT-B and healthy control groups (p < 0.0001). Moreover, the level of uHSP70 was significantly higher in the CAKUT-B group than in the control group (p < 0.0001), but was not different between the CAKUT subtypes (p > 0.05). Conclusion: Urine HSP70 can also be used to predict UTI in patients with CAKUT. Moreover, uHSP70 levels were higher in children with CAKUT during the non-infectious period than in healthy controls. This suggests that children with CAKUT are at risk of chronic non-infectious damage. Copyright © 2024 Aksu, Afonso, Akil, Alpay, Atmis, Aydog, Bakkaloglu, Bayazıt, Bayram, Bilge, Bulut, Cetinkaya, Comak, Demir, Dincel, Donmez, Durmus, Dursun, Dusunsel, Duzova, Ertan, Gedikbasi, Goknar, Guven, Hacihamdioglu, Jankauskiene, Kalyoncu, Kavukcu, Kenan, Kucuk, Kural, Litwin, Montini, Morello, Obrycki, Omer, Misirli Ozdemir, Ozkayin, Paripovic, Pehlivanoglu, Saygili, Schaefer, Schaefer, Sonmez, Tabel, Tas, Tasdemir, Teixeira, Tekcan, Topaloglu, Tulpar, Turkkan, Uysal, Uysalol, Vitkevic, Yavuz, Yel, Yildirim, Yildirim, Yildiz, Yuksel, Yurtseven and Yilmaz.
Pediatric kidney care experience after the 2023 Türkiye earthquake
(Oxford University Press, 2024) Bakkaloǧlu S.A.; Delibaş A.; Döven S.S.; Taner S.; Yavuz S.; Erfidan G.; Vatansever E.D.; Aynaci F.; Yilmaz K.; Taşdemir M.; Akaci O.; Akinci N.; Güven S.; Çiçek N.; Dursun I.; Keleşoǧlu E.; Sancaktar M.; Alaygut D.; Saygili S.; Yavaşcan Ö.; Yilmaz A.; Gülleroǧlu K.; Ertan P.; Demir B.K.; Poyrazoǧlu H.; Pinarbaşi S.; Gençler A.; Baştuǧ F.; Günay N.; Çeleǧen K.; Noyan A.; Parmaksiz G.; Avci B.; Çayci F.Ş.; Bayrakçi U.; Özlü S.G.; Aksoy Ö.Y.; Yel S.; Inal G.A.; Köse S.; Bayazit A.K.; Atmiş B.; Saribaş E.; Çaǧli Ç.; Tabel Y.; Elmas A.T.; Selçuk Ş.Z.; Kiliç B.D.; Kara M.A.; Büyükçelik M.; Balat A.; Tiryaki B.D.; Erdoǧdu B.; Aksu B.; Mahmudova G.; Dursun H.; Candan C.; Göknar N.; Mutlubaş F.; Çamlar S.A.; Başaran C.; Akbulut B.B.; Düzova A.; Gülhan B.; Oruç Ç.; Peru H.; Alpay H.; Türkkan Ö.N.; Gülmez R.; Çelakil M.; Doǧan K.; Bilge I.; Pehlivanoǧlu C.; Büyükkaragöz B.; Leventoǧlu E.; Alpman N.; Zeybek C.; Tülpar S.; Gülşan R.Y.Ç.; Kara A.; Gürgöze M.K.; Önder E.N.A.; Atikel Y.Ö.; Pul S.; Sönmez F.; Yildiz G.; Akman S.; Elmaci M.; Küçük N.; Yüksel S.; Kavaz A.; Nalçacioǧlu H.; Alparslan C.; Dinçel N.; Elhan A.H.; Sever L.
Background. Two earthquakes on 6 February 2023 destroyed 10 cities in Türkiye. We report our experience with pediatric victims during these catastrophes, with a focus on crush syndrome related-acute kidney injury (Crush-AKI) and death. Method. Web-based software was prepared. Patient demographics, time under rubble (TUR), admission laboratory data, dialysis, and kidney and overall outcomes were recorded. Results. A total of 903 injured children (median age 11.62 years) were evaluated. Mean TUR was 13 h (interquartile range 32.5, max 240 h). Thirty-one of 32 patients with a TUR of > 120 h survived. The patient who was rescued after 10 days survived. Two-thirds of the patients were given 50 mEq/L sodium bicarbonate in 0.45% sodium chloride solution on admission day. Fifty-eight percent of patients were given intravenous fluid (IVF) at a volume of 2000-3000 mL/m2 body surface area (BSA), 40% at 3000-4000 mL/m2 BSA and only 2% at > 4000 mL/m2 BSA. A total of 425 patients had surgeries, and 48 suffered from major bleeding. Amputations were recorded in 96 patients. Eighty-two and 66 patients required ventilator and inotropic support, respectively. Crush-AKI developed in 314 patients (36% of all patients). In all, 189 patients were dialyzed. Age > 15 years, creatine phosphokinase (CK) =20 950 U/L, TUR =10 h and the first-day IVF volume < 3000-4000 mL/m2 BSA were associated with Crush-AKI development. Twenty-two deaths were recorded, 20 of 22 occurring in patients with Crush-AKI and within the first 4 days of admission. All patients admitted after 7 days survived. Conclusions. These are the most extensive pediatric kidney disaster data obtained after an earthquake. Serum CK level was significantly associated with Crush-AKI at the levels of > 20 950 U/L, but not with death. Adolescent age and initial IVF of less than 3000-4000 mL/m2 BSA were also associated with Crush-AKI. Given that mildly injured victims can survive longer periods in the disaster field, we suggest uninterrupted rescue activity for at least 10 days. © The Author(s) 2024.
Urine soluble TLR4 levels may contribute to predict urinary tract infection in children: the UTILISE Study
(Springer Science and Business Media Deutschland GmbH, 2024) Aksu B.; Afonso A.C.; Akil I.; Alpay H.; Atmis B.; Aydog O.; Bayazıt A.K.; Bayram M.T.; Bilge I.; Bulut I.K.; Buyukkaragoz B.; Comak E.; Demir B.K.; Dincel N.; Donmez O.; Durmus M.A.; Dursun H.; Dusunsel R.; Duzova A.; Ertan P.; Gedikbasi A.; Goknar N.; Guven S.; Hacihamdioglu D.; Jankauskiene A.; Kalyoncu M.; Kavukcu S.; Kenan B.U.; Kucuk N.; Kural B.; Litwin M.; Montini G.; Morello W.; Obrycki L.; Omer B.; Oner H.A.; Ozdemir E.M.; Ozkayin N.; Paripovic D.; Pehlivanoglu C.; Saygili S.; Schaefer F.; Schaefer S.; Sonmez F.; Tabel Y.; Tas N.; Tasdemir M.; Teixeira A.; Tekcan D.; Topaloglu R.; Tulpar S.; Turkkan O.N.; Uysal B.; Uysalol M.; Vitkevic R.; Yavuz S.; Yel S.; Yildirim T.; Yildirim Z.Y.; Yildiz N.; Yuksel S.; Yurtseven E.; Yilmaz A.
Background: One of the most common bacterial infections in childhood is urinary tract infection (UTI). Toll-like receptors (TLRs) contribute to immune response against UTI recognizing specific pathogenic agents. Our aim was to determine whether soluble TLR4 (sTLR4), soluble TLR5 (sTLR5) and interleukin 8 (IL-8) can be used as biomarkers to diagnose UTI. We also aimed to reveal the relationship between urine Heat Shock Protein 70 (uHSP70) and those biomarkers investigated in this study. Methods: A total of 802 children from 37 centers participated in the study. The participants (n = 282) who did not meet the inclusion criteria were excluded from the study. The remaining 520 children, including 191 patients with UTI, 178 patients with non-UTI infections, 50 children with contaminated urine samples, 26 participants with asymptomatic bacteriuria and 75 healthy controls were included in the study. Urine and serum levels of sTLR4, sTLR5 and IL-8 were measured at presentation in all patients and after antibiotic treatment in patients with UTI. Results: Urine sTLR4 was higher in the UTI group than in the other groups. UTI may be predicted using 1.28 ng/mL as cut-off for urine sTLR4 with 68% sensitivity and 65% specificity (AUC = 0.682). In the UTI group, urine sTLR4 levels were significantly higher in pyelonephritis than in cystitis (p < 0.0001). Post-treatment urine sTLR4 levels in the UTI group were significantly lower than pre-treatment values (p < 0.0001). Conclusions: Urine sTLR4 may be used as a useful biomarker in predicting UTI and subsequent pyelonephritis in children with UTI. Graphical abstract: [Figure not available: see fulltext.]. © 2023, The Author(s), under exclusive licence to International Pediatric Nephrology Association.

Browsing by Author "Aksu B."

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