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    COVID-19 IN PEDIATRIC NEPHROLOGY CENTERS IN TURKEY
    (Springer, 2021) Bakkaloglu, Sevcan A.; Atikel, Yesim Ozdemir; LeventoGlu, Emre; Nalcacioglu, Hulya; Dursun, IsmaIl; PoyrazoGlu, Hakan; Dursun, Hasan
    [Abstract Not Available]
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    The Devastating Turkey-Syria Earthquake from the Perspective of Pediatric Nephrology
    (Galenos Publ House, 2023) Taner, Sevgin; Tabel, Yilmaz; Bakkaloglu, Sevcan A.
    Kahramanmaras was hit by two major earthquakes nine hours apart on February 6th, 2023, with magnitudes of 7.8 and 7.5 on the Richter scale, respectively. Ten other cities were also devastatingly affected by these earthquakes. More than 50 thousand people died in Turkey. The occurrence of two severe earthquakes on the same day in such a wide geographical area caused significant challenges. This disaster, with its devastating effects, focused attention on the significance of establishing a national and comprehensive emergency disaster plan prior to any disaster. Additionally, it highlighted the necessity of preparing a well-organized healthcare team capable of providing prompt and appropriate fluid replacement for pediatric patients in the early stages of a disaster. This is a crucial issue which must be addressed prior to major disasters. Another very important issue in this tragic disaster was the condition of chronically ill pediatric patients. Indeed, an emergency response is important not only for disaster victims, but also for those patients with chronic diseases in need of uninterrupted medical care. It is vital that individuals of all ages, as well as personnel from all sectors, receive the appropriate education, awareness, and knowledge on what actions to take, where to go, and where to gather in such situations.
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    Mutation Analysis Of Primary Hyperoxaluria Type 1
    (Springer, 2014) Isiyel, Emel; Bakkaloglu, Sevcan A.; Ezgu, Fatih S.; Caliskan, Salim; Akman, Sema; Akil, Ipek; Tabel, Yilmaz
    [Abstract Not Available]
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    Pediatric kidney care experience after the 2023 Türkiye earthquake
    (Oxford Univ Press, 2024) Bakkaloglu, Sevcan A.; Delibas, Ali; Doven, Serra Surmeli; Taner, Sevgin; Yavuz, Sevgi; Erfidan, Gokcen; Vatansever, Esra Danaci
    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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    Vascular access for hemodialysis and catheter-related bloodstream infections: a survey on preventive measures and treatment strategies by the EPDWG and ESPN Dialysis Working Group
    (Springer, 2026) Bakkaloglu, Sevcan A.; Leventoglu, Emre; Ezgu, Defne; Bayrakci, Umut Selda; Buder, Kathrin; Canpolat, Nur; Cappoli, Andrea
    The choice of vascular access (VA) plays a key role in the success of hemodialysis (HD). Despite their widespread use, central venous catheters (CVCs) are associated with higher rates of dysfunction, thrombosis, and catheter-related bloodstream infections (CRBSI). We investigated current practices in pediatric HD across European pediatric nephrology centers, focusing on VA choices, infection control measures, and CRBSI management. An online questionnaire was e-mailed to 119 members of the European Society for Pediatric Nephrology (ESPN) Dialysis Working Group and European Pediatric Dialysis Working Group (EPDWG). Descriptive statistics were used to summarize practices across centers, comparative analyses between centers in countries with Human Development Index (HDI) > 0.90 and < 0.90. Thirty-one centers across Europe participated in the survey. CVCs were the primary VA in 73.1% of the centers. Twenty (66.7%) centers reported malfunction as the most common CVC complication, followed by catheter thrombosis (19.4%) and CRBSI (12.9%). The diagnostic approach for CRBSI varied widely, with 35.4% of centers relying on a single positive catheter culture, while 57.9% did not collect a second culture from the peripheral vein or HD circuit. The most common empirical treatment was glycopeptides combined with third-generation cephalosporins. Nearly all centers used intravenous antibiotics for less than 3 weeks, and over half modified lock solutions with antibiotics following CRBSI diagnosis. Catheter removal practices were inconsistent, even in cases of severe infection. Centers reported a total of 548 HD patients. Exit-site infections and CRBSI were observed in 98 (17.8%) and 155 (28.2%) patients, respectively. CRBSI rates and CRBSI-related catheter replacements were significantly higher in centers from countries with HDI < 0.90 and in centers without a dedicated pediatric HD unit. Conclusion: The suboptimal adherence to current VA recommendations and wide variability in catheter care practices including the prevention, diagnosis, and management of CRBSI highlight the need for standardized pediatric-specific protocols to enhance catheter longevity and improve patient outcomes. What is Known: center dot Central venous catheters are widely used in pediatric hemodialysis but carry a high risk of complications, especially catheter-related bloodstream infections (CRBSI). What is New: center dot This multinational survey reveals significant variability in vascular access selection, CRBSI prevention, diagnosis, and treatment across European pediatric hemodialysis centers, with clear disparities by national HDI levels. center dot The findings highlight the need for standardization of vascular access care and CRBSI management and evidence-based pediatric-specific guidelines.