Browsing by Author "Delibas, A"

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    Pediatric kidney care experience after the 2023 Türkiye earthquake
    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.
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    EDUCATION STATUS OF PEDIATRIC DIALYSIS PATIENTS IN TURKEY
    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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    Hemolytic uremic syndrome outbreak in Turkey in 2011
    Ekinci, Z; Candan, C; Alpay, H; Canpolat, N; Akyüz, SG; Gündüz, Z; Dursun, I; Bek, K; Dursun, H; Isiyel, E; Öktem, F; Tabel, Y; Akil, I; Delibas, A; Gülleroglu, K; Akinci, N; Dinçel, N; Özkaya, O; Söylemezoglu, O
    The aim of this retrospective multicenter study was to define the epidemiological and clinical features and prognostic factors of the first diarrhea-related hemolytic uremic syndrome (D+HUS) outbreak in Turkey in 2011. All pediatric nephrology centers in Turkey were asked about D+HUS patients via e-mail. Seventy D+HUS patients (median age: 5.7 years) participated. The seasonal peak was around the 7th, 8th and 9th months with 44 cases, centered in the east Marmara region. No causative agent could be identified. The rate of neurological complications and mortality was 21.4% and 4.2%, respectively. Eculizumab was used in four cases. Two of them had severe neurological complications despite plasma exchange. Elevated polymorphonuclear leukocyte count during hospital admission was the predictor of both severe disease and poor outcome. Duration of prodrome was the predictor of poor outcome (p<0.05). In conclusion, the median age of the affected children was greater than in the previous reports, while clinical features and outcome were similar.
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    A nationwide retrospective study in Turkish children with nephrocalcinosis
    Döven, SS; Tülpar, S; Bastug, F; Yildirim, ZNY; Yilmaz, EK; Çiçek, N; Küçük, N; Çomak, E; Yazicioglu, B; Nalcacioglu, H; Delibas, A; Uysal, B; Agbas, A; Gemici, A; Günay, N; Ertan, P; Biyikli, N; Hacihamdioglu, DO; Elmaci, AM; Atikel, YO; Delebe, EÖÇ; Sever, FL; Gökçe, I; Öner, N; Akman, S; Aksu, B; Atmis, B; Yel, S; Yilmaz, A; Çelik, B; Dursun, I; Alpay, H
    Background/aim: 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. Materials and 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. Conclusion: 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.
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    Hemolytic uremic syndrome outbreak in Turkey in 2011
    Ekinci, Z; Candan, C; Alpay, H; Akyuz, SG; Gunduz, Z; Dursun, I; Caliskan, S; Canpolat, N; Bek, K; Dursun, H; Isiyel, E; Oktem, F; Tabel, Y; Akil, I; Delibas, A; Gulleroglu, K; Akinci, N; Dincel, N; Soylemezoglu, O
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    Kidney disease profile and encountered problems during follow-up in Syrian refugee children: a multicenter retrospective study
    Balat, A; Kilic, BD; Aksu, B; Kara, MA; Buyukcelik, M; Agbas, A; Eroglu, FK; Gungor, T; Alaygut, D; Yildiz, N; Bastug, F; Atmis, B; Melek, E; Elmaci, M; Tulpar, S; Pehlivanoglu, C; Doven, SS; Comak, E; Tabel, Y; Gemici, A; Uysal, B; Ozzorlar, GS; Kuçuk, N; Delibas, A; Ozcelik, G; Goknar, N; Dursun, I; Ertan, P; Ozunan, IA; 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.
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    Etiology and outcome of acute kidney injury in children
    Duzova, A; Bakkaloglu, A; Kalyoncu, M; Poyrazoglu, H; Delibas, A; Ozkaya, O; Peru, H; Alpay, H; Soylemezoglu, O; Gur-Guven, A; Bak, M; Bircan, Z; Cengiz, N; Akil, I; Ozcakar, B; Uncu, N; Karabay-Bayazit, A; Sonmez, F
    The aim of this prospective, multicenter study was to define the etiology and clinical features of acute kidney injury (AKI) in a pediatric patient cohort and to determine prognostic factors. Pediatric-modified RIFLE (pRIFLE) criteria were used to classify AKI. The patient cohort comprised 472 pediatric patients (264 males, 208 females), of whom 32.6% were newborns (median age 3 days, range 1-24 days), and 67.4% were children aged > 1 month (median 2.99 years, range 1 month-18 years). The most common medical conditions were prematurity (42.2%) and congenital heart disease (CHD, 11.7%) in newborns, and malignancy (12.9%) and CHD (12.3%) in children aged > 1 month. Hypoxic/ischemic injury and sepsis were the leading causes of AKI in both age groups. Dialysis was performed in 30.3% of newborns and 33.6% of children aged > 1 month. Mortality was higher in the newborns (42.6 vs. 27.9%; p < 0.005). Stepwise multiple regression analysis revealed the major independent risk factors to be mechanical ventilation [relative risk (RR) 17.31, 95% confidence interval (95% CI) 4.88-61.42], hypervolemia (RR 12.90, 95% CI 1.97-84.37), CHD (RR 9.85, 95% CI 2.08-46.60), and metabolic acidosis (RR 7.64, 95% CI 2.90-20.15) in newborns and mechanical ventilation (RR 8.73, 95% CI 3.95-19.29), hypoxia (RR 5.35, 95% CI 2.26-12.67), and intrinsic AKI (RR 4.91, 95% CI 2.04-11.78) in children aged > 1 month.
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    CLINICAL, EPIDEMIOLOGICAL AND PROGNOSTIC FEATURES OF CHILDREN WITH HEMOLYTIC UREMIC SYNDROME: MULTICENTER EXPERIENCE OF TURKEY
    Ertan, P; Bulut, IK; Guven, S; Cicek, N; Tulpar, S; Coskun, S; Donmez, O; Dusunsel, R; Serdaroglu, E; Bek, K; Kucuk, N; Akinci, N; Celakil, ME; Dursun, I; Yigit, G; Soylu, A; Bayram, MT; Bayrakci, US; Bakkaloglu, S; Ozdogan, EB; Koyun, M; Tufan, AK; Sonmez, F; Delibas, A; Tabel, Y; Ozkayin, N; Melek, E; Erdogan, H; Uysal, B; Bastug, F; Yavascan, O