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    Analyses of ultrasound-guided percutaneous pediatric kidney biopsy results: A single center experience
    (2020) Damar, Cagri; Demircioglu Kilic, Beltinge
    Aim: Percutaneous pediatric kidney biopsies (KB) performed in our center for the past 5 years were evaluated retrospectively. The relationship was examined between histopathological results and variables such as age, gender and ethnicity (Turkish and Syrian children).Material and Methods: A total 330 ultrasound-guided percutaneous pediatric KBs were performed in our center between January 2015 and September 2019. The study included 318 pediatric patients comprising 152 females and 178 males with a mean age of 9.50 ± 4.89 years (range, 2 months- 18 years). Indications, results and complications of the KBs were retrospectively evaluated. Histopathological results were statistically compared between genders and three age groups (0-2, 2-12 and 12-18 years of age). Comparisons were made between the ethnicities and histopathological results.Results: The most common indication for KB was nephrotic syndrome (n: 220, 66.7%). In the biopsy results, the most common primary (n: 230, 69.7%) and secondary (n: 74, 22.4%) glomerular diseases were focal segmental glomerulosclerosis (n: 101, 30.6%) and Henoch-Schönlein purpura nephritis (n: 41, 12.4%), respectively. A statistically significant relationship was determined between the biopsy results and age and gender. No statistically significant relationship was observed between the biopsy results and ethnicity.Conclusion: KB is an important intervention for the identification of glomerular diseases, requiring appropriate treatment in children. The ethnic origin of the patients had no effect on the frequency of the type of the diseases.
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    Evaluation of disease outcome with demographic,clinical and laboratory features of childhood-onset systemic lupus erythematosus: Single center experience
    (2020) Akbalik Kara, Mehtap; Demircioglu Kilic, Beltinge; Turkut Yilmaz, Asli; Buyukcelik, Mithat; Balat, Ayse
    Aim: To report demographic, clinical and laboratory findings with clinical outcome in childhood-onset systemic lupus erythematosus (cSLE)Material and Methods: Charts of all children with cSLE followed at pediatric rheumatology clinic of Gaziantep University between 2000-2016 were reviewed. Demographic data, history, age at diagnosis, physical examination, laboratory investigations, diagnostic criteria, follow-up duration and all therapeutic regimens were noted. The pediatric adaptation of the Systemic Lupus International Collaborating Clinics American College of Rheumatology Damage Index (PedSDI) has been used to evaluate the disease outcome.Results: The study population was consisted of 39 patients, 31 girls and 8 boys who were under 18 years at the time of diagnosis. Female: male ratio was 4.7:1. The mean age at disease onset was 10.5±4.56 years, and the mean follow-up duration was 26.4± 17.8 months. At the end of the follow-up period, fifteen patients (38.5%) had accrued damage (PedSDI≥1). We observed that renal, neuropsychiatric and musculoskeletal damage was the most frequent types of damage (38.5%). The damage score was higher in patients having increased number of diagnostic criteria at presentation (p:0.001).Conclusion: Although our study showed less damage index than patients from other countries, it has been well known that the damage accrual in SLE is higher in long term period, and mean follow-up period of our patients is lower than previous reports. We conclude that damage mainly affects renal, neurophyschiatric and musculoskeletal systems, and increased number of diagnostic criteria at presentation may cause much more damage.
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    Reasons for drop-out of peritoneal dialysis in pediatric patients: A single-center experience
    (2020) Demircioglu Kilic, Beltinge; Aksay Urgun, Melek
    Aim: Peritoneal dialysis is the first line treatment for patients with end-stage renal disease in childhood, due to a number of advantages offered. However, patients drop-out for various reasons during the course of the treatment. Identifying and preventing the emergence of those causes is very important for maintaining treatment with peritoneal dialysis. Material and Methods: Patients who were followed up between January 2005 and March 2019 in the peritoneal dialysis outpatient clinic of the Department of Pediatric Nephrology were examined retrospectively. The patients’ demographic data, as well as their reasons for drop-out of treatment were taken from patient files.Results: The results revealed that 89 patients (51.7% female, 48.3% male, mean age 83.17±56.78 months) underwent PD treatment over a period of 14 years and that 12 of them switched to another medical facility during their follow-up and that the peritoneal dialysis treatment of 34 (44.2%) of the remaining 77 patients was discontinued. The average duration of PD treatment was 38.21±27.93 months. In terms of the etiology of end-stage renal disease, urological anomalies (28.1%) and glomerular diseases (25.8%) were the most common. 18 patients (52.9%) dropped out of peritoneal dialysis due to hemodialysis, 11 (32.3%) due to transplantation, 4 (11.7%) due to death, and one (2.9%) due to a break from the treatment. Of the patients who switched to hemodialysis, 11 (61.2%) did so due to recurrent/resistant peritonitis, 4 (22.3%) due to failure of ultrafiltration, 2 (11%) due to mechanical problems (one case of hydrothorax, one case of leakage) while one (5.5%) patient voluntarily switched to hemodialysis.Conclusion: Although peritoneal dialysis offers many advantages in childhood, the transition to HD due to recurrent peritonitis remains the most common cause of peritoneal dialysis treatment discontinuation.