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    Assessment of bioelectrical impedance analysis for determining dry weight in pediatric hemodialysis patients; single center experience
    (2018) Ozkaya, Ozan; Nalcacioglu, Hulya
    Aim: Maintaining euvolemia is an important purpose in patients on hemodialysis therapy. Multiple-frequency bioimpedance spectroscopy (BIS) appears to be a useful and appropriate technique for assessing hydration status and body composition in hemodialysis patients.The aims of this study were to determine the pre and post hemodialysis hydration status of the pediatric hemodialysis patients by BIS and compare the dry weight determined by BIS to established by clinically. Material and Methods: Body Composition Monitor (BCM; Fresenius Medical Care, Germany) was performed in 13 pediatric hemodialysis patients in a single center. Patients were measured at the midweek session, once immediately before and once 30 minutes after dialysis. Pre-and post-HD weights, blood pressures, were collected on the day of the BCM measurements. Results: Seven (53.8%) of the 13 patients were male and 6 (46.2%) were female. The mean age ranged from 11.92 ± 3.13 (5.7-16) years and duration time ranged from 7 to 54 months, and the median duration of dialysis was 11 months. Dry weights which was determined clinically were higher than those calculated by BCM. A significant difference was found between mean values (34,71 ± 12,68 versus 33,71 ± 12,16 kg, Δ: 1 ± 1,51, p = 0.035). There was a high positive correlation between dry weights measured by BCM and dry weight established by nephrologists (r = 0.993, p <0.001). Conclusion: In assessing dry weight, BCM appears to be a quick and easy-to-use tool that can assist the clinician in hemodialysis treatment and optimizing patient outcomes.
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    Clinical value of late DMSA scan in predicting vesicoureteral reflux in children with febrile urinary tract infection
    (2020) Caglar, Ozgur; Nalcacioglu, Hulya; Yel, Sibel; Celik, Binnaz; Bastug, Funda
    Aim: To assess the usefulness of late dimercaptosuccinic acid (DMSA) renal scans in revealing high-grade vesicoureteral reflux (VUR). Material and Methods: Between July 2015 and December 2016, medical records of 112 patients who were admitted with febrile urinary tract infections (fUTIs) were retrospectively reviewed. The demographic information of the patients, and follow-up imaging [ultrasonography (USG), DMSA renal scans, and voiding cystourethrography] data were reviewed.Results: Of the 112 patients, 82 patients (73.2%) were female, 30 were male (26.8%), and the mean age was 7.04 ± 3.94 years. Recurrent fUTIs were detected in 65 patients (58%). Of the patients, 68 (60.7%) had abnormal urinary system USG, and 74 (66.1%) had abnormal DMSA renal scans. Vesicoureteral reflux (VUR) was detected in 63 patients (56.3%). VUR was present in 49 (66.2%) of 74 patients with scarring in DMSA and detected in 14 (38.8%) of 38 patients with normal DMSA scans. Significant agreement (kappa: 0.274 / p=0.003) was found between DMSA and VUR results. The sensitivity, specificity and positive predictive values of late DMSA renal scan to predict VUR were 77.8 %, 49 % and 63.2% respectively.Conclusion: Abnormal late DMSA scans carry a higher sensitivity and positive predictive value for predicting high-grade VUR in children with recurrent fUTIs. Late DMSA imaging seems a useful option in screening for high-grade VUR in children when the acute interventions are limited.
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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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    COVID-19 in pediatric nephrology centers in Turkey
    (Tubitak Scientific & Technological Research Council Turkey, 2022) Leventoglu, Emre; Ozdemir Atikel, Yesim; Nalcacioglu, Hulya; Dursun, Ismail; Dursun, Hasan; Yuruk Yildirim, Zeynep; Yildiz, Nurdan
    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.