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    Chronic Kidney Disease in Children in Turkey
    (2009) Bek, Kenan; Akman, Sema; Bilge, Ilmay; Topaloğlu, Rezan; Çalışkan, Salim; Peru, Harun; Cengiz, Nurcan; Söylemezoğlu, Oğuz
    [Abstract not Available]
  • Küçük Resim Yok
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    Chronic kidney disease in children in Turkey
    (SPRINGER, 2009) Bek, Kenan; Akman, Sema; Bilge, Ilmay; Topaloglu, Rezan; Caliskan, Salim; Peru, Harun; Cengiz, Nurcan
    To determine the incidence, etiology and treatment patterns of chronic kidney disease (CKD) in children a questionnaire was sent to pediatric nephrology centers in Turkey, asking them to report patients under the age of 19 years who had estimated glomerular filtration rates (GFRs) of a parts per thousand currency sign75 ml/min per 1.73 m(2) body surface area, diagnosed in 2005. Twenty-nine centers reported 282 patients (123 female/159 male; mean age 8.05 +/- 5.25 years). Urological problems such as vesicoureteral reflux (18.5%), obstructive uropathy (10.7%) and neurogenic bladder (15.1%) were the leading causes of CKD. The majority of the patients were in stage V (32.5%), IV (29.8%) or III (25.8%). Growth retardation (49.6%) and secondary hyperparathyroidism (72.4%) were very frequent. The GFR levels correlated positively with hemoglobin/hematocrit and calcium levels and negatively with phosphorus and parathyroid hormone (PTH) levels (P < 0.05). Renal replacement therapies were initiated in 35.8% of the patients, peritoneal dialysis in 23%, hemodialysis in 10.6% and transplantation in 2.2%. This was the first multi-center, epidemiologic study done in children with CKD in Turkey. The most striking result was the predominance of vesicoureteral reflux (VUR) or related urological problems as the underlying causes of CKD. Thus, early diagnosis and treatment of these conditions are of vital importance to decrease the incidence of CKD in children.
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    Etiology and Outcome of Acute Kidney Injury in Children
    (Springer, 2010) Düzova, Ali; Bakkaloğlu, Ayşin; Kalyoncu, Mukaddes; Poyrazoğlu, Hakan; Delibaş, Ali; Özkaya, Ozan; Peru, Harun; Alpay, Harika; Söylemezoğlu, Oğuz; Gür Güven, Ayfer; Bak, Mustafa; Bircan, Zelal; Cengiz, Nurcan; Akil, İpek; Özçakar, Birsin; Uncu, Nermin; Karabay Bayazit, Aysun; Sönmez, Ferah
    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.