Browsing by Author "Demir B.K."

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    COVID-19 in pediatric nephrology centers in Turkey
    (Turkiye Klinikleri, 2022) Leventoğlu E.; Atikel Y.Ö.; Nalçacioğlu H.; Dursun I.; Dursun H.; Yildirim Z.Y.; Yildiz N.; Aksoy G.K.; Taşdemir M.; Çelakil M.; Kiliç B.D.; Selçuk Ş.Z.; Canpolat N.; Çakici E.K.; Özlü S.G.; Tülpar S.; Yüksel S.; Atmiş B.; Döven S.S.; Taner S.; Ertan P.; Kavaz A.; Bayram M.T.; Kalyoncu M.; Gülleroğlu K.; Kabasakal C.; Demir B.K.; Çiçek R.Y.; Bilge I.; Dönmez O.; Kara A.; Yavaşcan Ö.; Özçelik G.; Yildirim D.G.; Güler M.A.; Sönmez F.; Poyrazoğlu H.; Akman S.; Topaloğlu R.; Alpay H.; Bakkaloğlu S.A.
    Background/aim: There is limited data on COVID-19 disease in children with kidney disease. We aimed to investigate the characteristics and prognosis of COVID-19 in pediatric nephrology patients in Turkey. Materials and methods: This was a national, multicenter, retrospective cohort study based on an online survey evaluating the data between 11th March 2020 and 11th March 2021 as an initial step of a detailed pediatric nephrology COVID-19 registry. Results: Two hundred and three patients (89 girls and 114 boys) were diagnosed with COVID-19. One-third of these patients (36.9%) were between 10–15 years old. Half of the patients were on kidney replacement therapy: kidney transplant (KTx) recipients (n = 56, 27.5%), patients receiving chronic hemodialysis (n = 33, 16.3%) and those on peritoneal dialysis (PD) (n = 18, 8.9%). Fifty-four (26.6%) children were asymptomatic. Eighty-two (40.3%) patients were hospitalized and 23 (28%) needed intensive care unit admission. Fifty-five percent of the patients were not treated, while the remaining was given favipiravir (20.7%), steroid (16.3%), and hydroxychloroquine (11.3%). Acute kidney injury developed in 19.5% of hospitalized patients. Five (2.4%) had MIS-C. Eighty-three percent of the patients were discharged without any apparent sequelae, while 7 (3.4%) died. One hundred and eight health care staff were infected during the study period. Conclusion: COVID-19 was most commonly seen in patients who underwent KTx and received HD. The combined immunosuppressive therapy and frequent exposure to the hospital setting may increase these patients’ susceptibility. Staff infections before vaccination era were alarming, various precautions should be taken for infection control, particularly optimal vaccination coverage. © TÜBİTAK.
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    The 6th of February earthquake and the Turkish Society of Pediatric Nephrology—organizational aspects of pediatric kidney care
    (Oxford University Press, 2023) Bakkaloglu S.A.; Yavaşcan Ö.; Yılmaz A.; Gülleroglu K.; Demir B.K.; Ertan P.; Poyrazoglu H.
    [No abstract available]
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    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.
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    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.
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    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.
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    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.
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    10 Years of Antenatal Hydronephrosis Experience: Comparing Two Different Guidelines
    (Georg Thieme Verlag, 2024) Ensari E.; Yavascan O.; Alparslan C.; Oncel E.P.; Maden A.A.; Demir B.K.; Alaygut D.; Ozdemir T.
    Background Antenatal hydronephrosis refers to the dilation of the renal pelvis and/or calyces in the developing fetus. The challenge lies in distinguishing between cases that warrant long-Term follow-up or surgical intervention and those with transient hydronephrosis that require minimal invasive investigations. Materials and Methods Our study aimed to assess and contrast the efficacy of the 2015 Congenital Anomalies of Kidney and Urinary Tract Guideline from the Turkish Society of Pediatric Nephrology with the Tepecik Antenatal Hydronephrosis Guideline, which was previously employed in our hospital. We conducted a comparative analysis of demographic data, outcome conditions, additional imaging requirements and quantities, radiation exposures, and rates of surgical interventions between two groups. Results Group 2 had a significantly higher detection rate of Vesicoureteral Reflux via voiding cystourethrogram at 38.5% compared to Group 1's 13.4% (p<0.01). The incidence of abnormal findings with dimercaptosuccinic acid was similar between Group 1 (28.5%) and Group 2 (26.4%) (p>0.01), but Group 2 had a higher rate of obstruction diagnosis at 68.8% versus Group 1's 29.4% (p<0.01). Group 1 had greater median radiation exposure (500 mrem vs. 200 mrem, p<0.01), and a higher proportion of patients underwent surgery (34.2% vs. 21.9%, p<0.01). Conclusion This study showed that the new guideline required fewer tests, was less invasive, and exposed patients to less radiation than the old guideline. © 2024. Thieme. All rights reserved.