Browsing by Author "Bayazit, AK"

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    Urine soluble TLR4 levels may contribute to predict urinary tract infection in children: the UTILISE Study
    (SPRINGER) Aksu, B; Afonso, AC; Akil, I; Alpay, H; Atmis, B; Aydog, O; Bayazit, AK; Bayram, MT; Bilge, I; Bulut, IK; Buyukkaragoz, B; Comak, E; Demir, BK; Dincel, N; Donmez, O; Durmus, MA; Dursun, H; Dusunsel, R; Duzova, A; Ertan, P; Gedikbasi, A; Goknar, N; Guven, S; Hacihamdioglu, D; Jankauskiene, A; Kalyoncu, M; Kavukcu, S; Kenan, BU; Kucuk, N; Kural, B; Litwin, M; Montini, G; Morello, W; Obrycki, L; Omer, B; Oner, HA; Ozdemir, EM; 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, ON; Uysal, B; Uysalol, M; Vitkevic, R; Yavuz, S; Yel, S; Yildirim, T; Yildirim, ZY; 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.
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    EDUCATION STATUS OF PEDIATRIC DIALYSIS PATIENTS IN TURKEY
    (SPRINGER) Delibas, A; Ekim, M; Yildirim, ZY; Düsünsel, R; Kara, A; Noyan, A; Bayazit, AK; Conkar, S; Yazicioglu, BÖ; Serdaroglu, E; Aksoy, GK; Akinci, N; Yilmaz, D; Bek, K; Ertan, P; Gürgöze, MK; Kabasakal, C; Döven, SS; Türkkan, ON; Günay, N; Parmaksiz, G; Melek, E; Erdogan, S; Ezgü, SAB; Sever, L
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    MEMBRANOUS NEPHROPATHY IN CHILDREN: A RETROSPECTIVE OBSERVATIONAL MULTICENTRE STUDY IN TURKEY
    (SPRINGER) Gokce, I; Sak, M; Bayram, MT; Aksoy, O; Melek, E; Yildirim, ZNY; Tekcan, D; Pinarbasi, AS; Soyaltin, E; Goknar, N; Serdaroglu, E; Ozcelik, G; Nalcacioglu, H; Tulpar, S; Ozkayin, N; Ozdogan, EB; Ertan, P; Buyan, N; Aydog, O; Bayrakci, US; Bayazit, AK; Soylu, A; Kavukcu, S; Yilmaz, A; Anarat, A
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    Urinary HSP70 improves diagnostic accuracy for urinary tract infection in children: UTILISE study
    (SPRINGER) Yilmaz, A; Afonso, AC; Akil, I; Aksu, B; Alpay, H; Atmis, B; Aydog, O; Bayram, MT; Bilge, I; Bulut, IK; Buyukkaragoz, B; Comak, E; Demir, BK; Dincel, N; Donmez, O; Durmus, MA; Dursun, H; Dusunsel, R; Duzova, A; Ertan, P; Gedikbasi, A; Goknar, N; Guven, S; Hacihamdioglu, D; Jankauskiene, A; Kalyoncu, M; Kavukcu, S; Kenan, BU; Kucuk, N; Kural, B; Montini, G; Morello, W; Nayir, A; Obrycki, L; Omer, B; Ozdemir, EM; 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, ON; Uysal, B; Uysalol, M; Vaiciuniene, D; Yavuz, S; Yel, S; Yildirim, T; Yildirim, ZY; Yildiz, N; Yuksel, S; Yurtseven, E; Schaefer, F; Topaloglu, R; Bayazit, AK; Litwin, M
    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.
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    THE ROLE OF ANTIMICROBIAL POLYPEPTIDES FOR THE PREDICTING OF URINARY TRACT INFECTION: UTILISE STUDY
    (SPRINGER) Yildirim, ZY; Afonso, AC; Akil, I; Aksu, B; Alpay, H; Atmis, B; Aydog, O; Bakkaloglu, S; Bayazit, AK; Bayram, MT; Bilge, I; Bulut, IK; Comak, E; Kasap-Demir, B; Delebe, OC
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    Reno-vascular hypertension in childhood: a nationwide survey
    (SPRINGER) Bayazit, AK; Yalcinkaya, F; Cakar, N; Duzova, A; Bircan, Z; Bakkaloglu, A; Canpolat, N; Kara, N; Sirin, A; Ekim, M; Oner, A; Akman, S; Mir, S; Baskin, E; Poyrazoglu, HM; Noyan, A; Akil, I; Bakkaloglu, S; Soylu, A
    Renovascular disease accounts for 8-10% of all cases of paediatric hypertension, whereas, in adults, its incidence is approximately 1%. The Turkish Paediatric Hypertension Group aimed to create the first registry database for childhood renovascular hypertension in Turkey. Twenty of the 28 paediatric nephrology centres in Turkey responded to the survey and reported 45 patients (27 girls, 18 boys) with renovascular hypertension between 1990 and 2005. The age at presentation ranged from 20 days to 17 years. The mean blood pressure at the diagnosis was 169/110 mmHg. Chief complaints of symptomatic patients were headache (38%), seizure (18%), epistaxis (4%), growth retardation (4%), cognitive dysfunction (4%), polyuria (2%), palpitation (2%), and hemiplegia (2%). Renovascular hypertension was found incidentally in 11 children. The diagnosis of renovascular hypertension was established with conventional angiography in 39 patients, MR angiography in three, CT angiography in two, and captopril diethylene triamine penta-acetic acid (DTPA) scintigraphy in one patient. Twenty-one children had bilateral renal artery stenosis and 24 had unilateral renal artery stenosis. Of these, 14 (31%) had fibromuscular dysplasia; 12 (27%) Takayasu's arteritis; six (13%) neurofibromatosis; two (5%) Williams syndrome; one (2%) Kawasaki disease; one (2%) mid-aortic syndrome; one (2%) extrinsic compression to the renal artery, and eight (18%) unspecified bilateral renal artery stenosis. Hypertension was controlled with antihypertensive drugs in 17 patients. Percutaneous transluminal angioplasty (PTRA) or surgery had to be performed in 28 patients: PTRA in 16 patients, PTRA + surgery in one patient and surgery in 11 patients (four nephrectomies). The importance of vasculitic disease, especially Takayasu's arteritis, should not be underestimated in children with renovascular hypertension.
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    Effects of nutritional vitamin D supplementation on markers of bone and mineral metabolism in children with chronic kidney disease
    (OXFORD UNIV PRESS) Lerch, C; Shroff, R; Wan, M; Rees, L; Aitkenhead, H; Bulut, IK; Thurn, D; Bayazit, AK; Niemirska, A; Canpolat, N; Duzova, A; Azukaitis, K; Yilmaz, E; Yalcinkaya, F; Harambat, J; Kiyak, A; Alpay, H; Habbig, S; Zaloszyc, A; Soylemezoglu, O; Candan, C; Rosales, A; Melk, A; Querfeld, U; Leifheit-Nestler, M; Sander, A; Schaefer, F; Haffner, D; Cortina, G; Arbeiter, K; Dusek, J; Harambat, J; Ranchin, B; Fischbach, M; Zalosczyk, A; Querfeld, U; Habbig, S; Galiano, M; Büscher, R; Gimpel, C; Kemper, M; Melk, A; Thurn, D; Schaefer, F; Doyon, A; Wühl, E; Pohl, M; Wygoda, S; Jeck, N; Kranz, B; Wigger, M; Montini, G; Lugani, F; Testa, S; Vidal, E; Matteucci, C; Picca, S; Jankauskiene, A; Azukaitis, K; Zurowska, A; Drodz, D; Tkaczyk, M; Urasinski, T; Litwin, M; Niemirska, A; Szczepanska, M; Texeira, A; Peco-Antic, A; Bucher, B; Laube, G; Anarat, A; Bayazit, AK; Yalcinkaya, F; Basin, E; Cakar, N; Soylemezoglu, O; Duzova, A; Bilginer, Y; Erdogan, H; Donmez, O; Balat, A; Kiyak, A; Caliskan, S; Canpolat, N; Candan, C; Civilibal, M; Emre, S; Alpay, H; Ozcelik, G; Mir, S; Sözeri, B; Yavascan, O; Tabel, Y; Ertan, P; Yilmaz, E; Shroff, R; Prytula, A; Bachetta, J; Haffner, D; Klaus, G; Gessner, M; Schmitt, CP; Stabouli, S; Reusz, G; Verrina, E; Groothoff, J; Tondel, C; Gamero, MA; Petrosyan, E; Bakkaloglu, SA; Dursun, I; Shroff, R
    Background. We investigated the effects of nutritional vitamin D supplementation on markers of bone and mineral metabolism, i.e. serum levels of fibroblast growth factor 23 (FGF23), Klotho, bone alkaline phosphatase (BAP) and sclerostin, in two cohorts with chronic kidney disease (CKD). Methods. In all, 80 vitamin D-deficient children were selected: 40 with mild to moderate CKD from the ERGO study, a randomized trial of ergocalciferol supplementation [ estimated glomerular filtration rate (eGFR) 55 mL/min/1.73 m(2)], and 40 with advanced CKD from the observational Cardiovascular Comorbidity in Children with Chronic Kidney Disease (4C) study (eGFR 24 mL/min/1.73 m2). In each study, vitamin D supplementation was started in 20 children and 20 matched children not receiving vitamin D served as controls. Measures were taken at baseline and after a median period of 8 months. Age- and gender-related standard deviation scores (SDSs) were calculated. Results. Before vitamin D supplementation, children in the ERGO study had normal FGF23 (median 0.31 SDS) and BAP (-0.10 SDS) but decreased Klotho and sclerostin (-0.77 and -1.04 SDS, respectively), whereas 4C patients had increased FGF23 (3.87 SDS), BAP (0.78 SDS) and sclerostin (0.76 SDS) but normal Klotho (-0.27 SDS) levels. Vitamin D supplementation further increased FGF23 in 4C but not in ERGO patients. Serum Klotho and sclerostin normalized with vitamin D supplementation in ERGO but remained unchanged in 4C patients. BAP levels were unchanged in all patients. In the total cohort, significant effects of vitamin D supplementation were noted for Klotho at eGFR 40-70 mL/min/1.73 m(2). Conclusions. Vitamin D supplementation normalized Klotho and sclerostin in children with mild to moderate CKD but further increased FGF23 in advanced CKD.
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    AUTOSOMAL-DOMINANT POLYCYSTIC KIDNEY DISEASE IN CHILDREN: PRELIMINARY RESULTS OF A TURKISH NATIONAL, MULTICENTER STUDY
    (SPRINGER) Ozdogan, EB; Nalcacioglu, H; Alpay, H; Dursun, I; Bek, K; Demir, BK; Tekcan, D; Acikgoz, Y; Melek, E; Yazilitas, F; Bayram, MT; Yildirim, ZY; Gokce, I; Yilmaz, D; Tulpar, S; Isik, G; Ertan, P; Agbas, A; Aydog, O; Mutlubas, F; Bircan, Z; Cicek, N; Bayazit, AK; Soylu, A; Soyaltin, E; Celakil, ME; Yildiz, N
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    Renovascular hypertension in childhood: A nation-wide survey
    (OXFORD UNIV PRESS) Bayazit, AK; Yalcinkaya, F; Cakar, N; Duzova, A; Bircan, Z; Aslan, S; Bakkaloglu, A; Canpolat, N; Kara, N; Sirin, A; Ekim, M; Oner, A; Akman, S; Mir, S; Baskin, E; Poyrazoglu, H; Noyan, A; Akil, I; Bakkaloglu, S; Soylu, A
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    URINARY HSP70 IMPROVES DIAGNOSTIC ACCURACY FOR URINARY TRACT INFECTION IN CHILDREN: UTILISE STUDY
    (SPRINGER) Yilmaz, A; Afonso, AC; Akil, I; Aksu, B; Alpay, H; Atmis, B; Aydog, O; Bayazit, AK; Bayram, MT; Bilge, I; Bulut, IK; Buyukkaragoz, B; Comak, E; Demir, BK; Dincel, N; Donmez, O; Durmus, MA; Dursun, H; Dusunsel, R; Duzova, A; Ertan, P; Gedikbasi, A; Goknar, N; Guven, S; Hacihamdioglu, D; Jankauskiene, A; Kalyoncu, M; Kavukcu, S; Kenan, BU; Kucuk, N; Kural, B; Litwin, M; Montini, G; Morello, W; Nayir, A; Obrycki, L; Omer, B; Ozdemir, EM; 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, ON; Uysal, B; Uysalol, M; Vaiciuniene, D; Yavuz, S; Yel, S; Yildirim, T; Yildirim, ZY; Yildiz, N; Yuksel, S; Yurtseven, E; Schaefer, F; Topaloglu, R
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    Pediatric kidney care experience after the 2023 Türkiye earthquake
    (OXFORD UNIV PRESS) Bakkaloglu, SA; Delibas, A; Döven, SS; Taner, S; Yavuz, S; Erfidan, G; Vatansever, ED; Aynaci, F; Yílmaz, K; Tasdemir, M; Akaci, O; Akinci, N; Güven, S; Çiçek, N; Dursun, I; Kelesoglu, E; Sancaktar, M; Alaygut, D; Saygili, S; Yavascan, Ö; Yilmaz, A; Gülleroglu, K; Ertan, P; Demir, BK; Poyrazoglu, H; Pinarbasi, S; Gençler, A; Bastug, F; Günay, N; Çelegen, K; Noyan, A; Parmaksiz, G; Avci, B; Çayci, FS; Bayrakçi, U; Özlü, SG; Aksoy, ÖY; Yel, S; Inal, GA; Köse, S; Bayazit, AK; Atmis, B; Saribas, E; Çagli, Ç; Tabel, Y; Elmas, AT; Selçuk, SZ; Kiliç, BD; Kara, MA; Büyükçelik, M; Balat, A; Tiryaki, BD; Erdogdu, B; Aksu, B; Mahmudova, G; Dursun, H; Candan, C; Göknar, N; Mutlubas, F; Çamlar, SA; Basaran, C; Akbulut, BB; Düzova, A; Gülhan, B; Oruç, Ç; Peru, H; Alpay, H; Türkkan, ÖN; Gülmez, R; Çelakil, M; Dogan, K; Bilge, I; Pehlivanoglu, C; Büyükkaragöz, B; Leventoglu, E; Alpman, N; Zeybek, C; Tülpar, S; Gülsan, RYÇ; Kara, A; Gürgöze, MK; Önder, ENA; Atikel, YÖ; Pul, S; Sönmez, F; Yildiz, G; Akman, S; Elmaci, M; Küçük, N; Yüksel, S; Kavaz, A; Nalçacioglu, H; Alparslan, C; Dinçel, N; Elhan, AH; Sever, L
    Background. Two earthquakes on 6 February 2023 destroyed 10 cities in Turkiye. 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/m(2) body surface area (BSA), 40% at 3000-4000 mL/m(2) BSA and only 2% at >4000 mL/m(2) 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/m(2) 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.