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Doğan ÇS, Taner S, Tiryaki BD, Alaygut D, Özkayın N, Kara A, Gençler A, Pınarbaşı AS, Nalçacıoğlu H, Yüksel S, Akacı O, Yılmaz EK, Yavuz S, Doğan K, Gülşan RYÇ, Aksoy GK, Çiçek N, Aksu B, Küçük N, Altugan FŞ, Selçuk ŞZ, Baştuğ F, Erfidan G, Atmış B, Gökçeoğlu AU, Önder ENA, Elmacı AM, Cengiz N, Gülleroğlu K, Yılmaz EB, Tayfur AÇ, Yılmaz GG, Yel Sİ, Pehlivanoğlu C, Akgün C, Kara MA, Kılıç BD, Şimşek ÖÖ, Yucal M, Ağar BE, Gürgöze MK, Yağmur İ, Madsar Ö, Karalı DT, Girişgen İ, Bodur ED, Çomak E, Gökçe İ, Kaya M, Tabel Y, Günay N, Gülmez R, Çalışkan S. Characteristics and predictors of chronic kidney disease in children with myelomeningocele: a nationwide cohort study. Pediatr Nephrol 2024; 39:1509-1519. [PMID: 38040872 DOI: 10.1007/s00467-023-06212-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/06/2023] [Accepted: 10/18/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Myelomeningocele (MMC) is highly prevalent in developing countries, and MMC-related neurogenic bladder is an important cause of childhood chronic kidney disease (CKD). This nationwide study aimed to evaluate demographic and clinical features of pediatric patients with MMC in Turkey and risk factors associated with CKD stage 5. METHODS Data from children aged 0-19 years old, living with MMC in 2022, were retrospectively collected from 27 pediatric nephrology centers. Patients > 1 year of age without pre-existing kidney abnormalities were divided into five groups according to eGFR; CKD stages 1-5. Patients on dialysis, kidney transplant recipients, and those with eGFR < 15 ml/min/1.73 m2 but not on kidney replacement therapy at time of study constituted the CKD stage 5 group. RESULTS A total of 911 (57.8% female) patients were enrolled, most of whom were expectantly managed. Stages 1-4 CKD were found in 34.3%, 4.2%, 4.1%, and 2.4%, respectively. CKD stage 5 was observed in 5.3% of patients at median 13 years old (range 2-18 years). Current age, age at first abnormal DMSA scan, moderate-to-severe trabeculated bladder on US and/or VCUG, and VUR history were independent risk factors for development of CKD stage 5 (OR 0.752; 95%; CI 0.658-0.859; p < 0.001; OR 1.187; 95% CI 1.031-1.367; p = 0.017; OR 10.031; 95% CI 2.210-45.544; p = 0.003; OR 2.722; 95% CI 1.215-6.102; p = 0.015, respectively). Only eight CKD stage 5 patients underwent surgery related to a hostile bladder between 1 and 15 years old. CONCLUSION MMC-related CKD is common in childhood in Turkey. A proactive approach to neurogenic bladder management and early protective surgery in selected cases where conservative treatment has failed should be implemented to prevent progressive kidney failure in the pediatric MMC population in our country.
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Affiliation(s)
- Çağla Serpil Doğan
- Division of Pediatric Nephrology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey.
| | - Sevgin Taner
- Division of Pediatric Nephrology, Adana City Hospital, Adana, Turkey
| | - Betül Durucu Tiryaki
- Division of Pediatric Nephrology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Demet Alaygut
- Division of Pediatric Nephrology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Neşe Özkayın
- Division of Pediatric Nephrology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Aslıhan Kara
- Division of Pediatric Nephrology, Faculty of Medicine, Fırat University, Elazığ, Turkey
| | - Aylin Gençler
- Division of Pediatric Nephrology, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
| | - Ayşe Seda Pınarbaşı
- Division of Pediatric Nephrology, Diyarbakır Children's Hospital, Diyarbakır, Turkey
| | - Hülya Nalçacıoğlu
- Division of Pediatric Nephrology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Selçuk Yüksel
- Division of Pediatric Nephrology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Okan Akacı
- Division of Pediatric Nephrology, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Esra Karabağ Yılmaz
- Division of Pediatric Nephrology, Cerrahpaşa Medical Faculty, İstanbul University - Cerrahpaşa, İstanbul, Turkey
| | - Sevgi Yavuz
- Division of Pediatric Nephrology, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Kenan Doğan
- Division of Pediatric Nephrology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Rumeysa Yasemin Çiçek Gülşan
- Division of Pediatric Nephrology, University of Health Sciences, Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Gülşah Kaya Aksoy
- Division of Pediatric Nephrology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Neslihan Çiçek
- Division of Pediatric Nephrology, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Bağdagül Aksu
- Division of Pediatric Nephrology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Nuran Küçük
- Division of Pediatric Nephrology, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
| | - Fatma Şemsa Altugan
- Division of Pediatric Nephrology, University of Health Sciences, Bilkent City Hospital, Ankara, Turkey
| | - Şenay Zırhlı Selçuk
- Division of Pediatric Nephrology, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Funda Baştuğ
- Division of Pediatric Nephrology, Kayseri City Hospital, Kayseri, Turkey
| | - Gökçen Erfidan
- Division of Pediatric Nephrology, University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Diyarbakir, Turkey
| | - Bahriye Atmış
- Division of Pediatric Nephrology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Arife Uslu Gökçeoğlu
- Division of Pediatric Nephrology, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | | | - Ahmet Mithat Elmacı
- Division of Pediatric Nephrology, Faculty of Medicine, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - Nurcan Cengiz
- Division of Pediatric Nephrology, Faculty of Medicine, Sıtkı Koçman University, Muğla, Turkey
| | - Kaan Gülleroğlu
- Division of Pediatric Nephrology, Faculty of Medicine, Başkent University, Ankara, Turkey
| | - Ebru Bekiroğlu Yılmaz
- Division of Pediatric Nephrology, University of Health Sciencies, Dr. Behçet Uz Children's Hospital, Izmir, Turkey
| | - Aslı Çelebi Tayfur
- Division of Pediatric Nephrology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
| | | | - Sİbel Yel
- Division of Pediatric Nephrology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Cemile Pehlivanoğlu
- Division of Pediatric Nephrology, Faculty of Medicine, Koç University, İstanbul, Turkey
| | - Cihangir Akgün
- Division of Pediatric Nephrology, Faculty of Medicine, İstanbul Medipol University, İstanbul, Turkey
| | - Mehtap Akbalık Kara
- Division of Pediatric Nephrology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | | | - Özgür Özdemir Şimşek
- Division of Pediatric Nephrology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Melike Yucal
- Division of Pediatric Nephrology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Buket Esen Ağar
- Division of Pediatric Nephrology, Faculty of Medicine, Fırat University, Elazığ, Turkey
| | - Metin Kaya Gürgöze
- Division of Pediatric Nephrology, Faculty of Medicine, Fırat University, Elazığ, Turkey
| | - İsmail Yağmur
- Division of Pediatric Urology, Faculty of Medicine, Harran University, Urfa, Turkey
| | - Ömer Madsar
- Department of Urology, Faculty of Medicine, Harran University, Urfa, Turkey
| | - Demet Tekcan Karalı
- Division of Pediatric Nephrology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - İlknur Girişgen
- Division of Pediatric Nephrology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Ece Demirci Bodur
- Division of Pediatric Nephrology, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Elif Çomak
- Division of Pediatric Nephrology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - İbrahim Gökçe
- Division of Pediatric Nephrology, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Mehtap Kaya
- Division of Pediatric Nephrology, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
| | - Yılmaz Tabel
- Division of Pediatric Nephrology, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Neslihan Günay
- Division of Pediatric Nephrology, Kayseri City Hospital, Kayseri, Turkey
| | - Rüveyda Gülmez
- Division of Pediatric Nephrology, University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Diyarbakir, Turkey
| | - Salim Çalışkan
- Division of Pediatric Nephrology, Cerrahpaşa Medical Faculty, İstanbul University - Cerrahpaşa, İstanbul, Turkey
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Yılmaz EK, Saygılı S, Musayeva G, Gülmez R, Ağbaş A, Özlük Y, Canpolat N. A case of crescentic glomerulonephritis with exacerbation of pre-existing IgA nephropathy after COVID-19. Turk J Pediatr 2024; 66:128-133. [PMID: 38523389 DOI: 10.24953/turkjped.2023.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
BACKGROUND Relapses or new-onset IgA nephropathy (IgAN) have been documented in patients after vaccination against SARS-CoV-2; however, only one adult patient has been reported in whom pre-existing IgAN worsened during coronavirus disease 2019 (COVID-19). CASE We present the first pediatric case with biopsy-proven IgAN and genetically confirmed Alport syndrome, who developed end-stage kidney disease after an exacerbation of IgAN associated with COVID-19. The patient`s basal serum creatinine was 0.7-0.9 mg/dL before infection. He had not been vaccinated against COVID-19. He was admitted to the hospital with edema, hypertension, an elevated serum creatinine of 4.7 mg/ dL, and massive proteinuria. Three months before admission, he had been admitted to another hospital with COVID -19 and an elevated serum creatinine (1.9 mg/dL), but no biopsy had been performed at that time. The kidney biopsy revealed IgAN with 50% fibrocellular crescents with sclerosed glomeruli, tubular atrophy, and interstitial fibrosis. His serum creatinine did not decrease even after five administrations of pulse steroids, and hemodialysis was initiated. CONCLUSION In conclusion, COVID -19 may pose a high risk for exacerbation of pre-existing glomerular disease. It is therefore necessary to closely monitor the kidney function of patients with underlying glomerulonephritis during and after COVID-19 and consider an early biopsy if serum creatinine does not return to baseline levels. In addition, this case report highlights the clinical importance of the co-occurence of IgAN and Alport syndrome.
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Affiliation(s)
- Esra Karabağ Yılmaz
- Department of Pediatric Nephrology, İstanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, İstanbul
| | - Seha Saygılı
- Department of Pediatric Nephrology, İstanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, İstanbul
| | - Gülüstan Musayeva
- Department of Pediatrics, İstanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, İstanbul
| | - Rüveyda Gülmez
- Department of Pediatric Nephrology, İstanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, İstanbul
| | - Ayşe Ağbaş
- Department of Pediatric Nephrology, İstanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, İstanbul
| | - Yasemin Özlük
- Department of Pathology, İstanbul University Faculty of Medicine, İstanbul, Türkiye
| | - Nur Canpolat
- Department of Pediatric Nephrology, İstanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, İstanbul
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Saygılı S, Koşukcu C, Baştuğ T, Doğan ÖA, Yılmaz EK, Kalyoncu AU, Ağbaş A, Canpolat N, Çalışkan S, Ozaltin F. A novel homozygous missense variant in TBC1D31 in a consanguineous family with congenital anomalies of the kidney and urinary tract (CAKUT). Clin Genet 2023; 104:679-685. [PMID: 37468454 DOI: 10.1111/cge.14406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/28/2023] [Accepted: 07/08/2023] [Indexed: 07/21/2023]
Abstract
Congenital anomalies of the kidney and urinary tract (CAKUT) is the leading cause of chronic kidney disease in the first three decades of life. Until now, more than 180 monogenic causes of isolated or syndromic CAKUT have been described. In addition, copy number variants (CNV) have also been implicated, however, all of these causative factors only explain a small fraction of patients with CAKUT, suggesting that additional yet-to-be-discovered novel genes are present. Herein, we report three siblings (two of them are monozygotic twin) of a consanguineous family with CAKUT. Whole-exome sequencing identified a homozygous variant in TBC1D31. Three dimensional protein modeling as well as molecular dynamics simulations predicted it as pathogenic. We therefore showed for the first time an association between a homozygous TBC1D31 variant with CAKUT in humans, expanding its genetic spectrum.
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Affiliation(s)
- Seha Saygılı
- Department of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Can Koşukcu
- Department of Bioinformatics, Hacettepe University Institute of Health Sciences, Ankara, Türkiye
| | - Turgut Baştuğ
- Department of Biophysics, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
| | - Özlem Akgün Doğan
- Department of Pediatric Genetics, Faculty of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Türkiye
| | - Esra Karabağ Yılmaz
- Department of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Ayşe Uçar Kalyoncu
- Department of Pediatric Radiology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Ayşe Ağbaş
- Department of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Nur Canpolat
- Department of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Salim Çalışkan
- Department of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Fatih Ozaltin
- Department of Bioinformatics, Hacettepe University Institute of Health Sciences, Ankara, Türkiye
- Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
- Nephrogenetics Laboratory, Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
- Center for Genomics and Rare Diseases, Hacettepe University, Ankara, Türkiye
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Saygılı SK, Karabağ Yılmaz E, Kezer S, Dedeoğlu R, Kaplan Kılıç Ş, Çiçek RY, Gülmez R, Demirgan EB, Ağbaş A, Eliçevik M, Çalışkan S, Canpolat N. Cardiometabolic Risk Factors in Pediatric Kidney Transplant Recipients. Turk Arch Pediatr 2023; 58:220-225. [PMID: 36856361 PMCID: PMC10081001 DOI: 10.5152/turkarchpediatr.2023.22310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVE There is an increased risk of obesity and metabolic syndrome among kidney transplant recipients, which adversely affects cardiovascular and renal outcomes in these patients. The present study aims to investigate the prevalence of metabolic syndrome in pediatric kidney transplant recipients and the associations of metabolic syndrome with cardiovascular disease and graft function. MATERIALS AND METHODS This cross-sectional, single-center study included 52 kidney transplant recipients (27 males) transplanted before 18 years of age. All subjects underwent a comprehensive assessment that included anthropometric and blood pressure measurements and laboratory tests. Metabolic syndrome was defined based on the recent recommendations of the Pediatric Renal Nutrition Taskforce. Left ventricular hypertrophy was assessed as a risk factor for cardiovascular disease, and estimated glomerular filtration rate was assessed to determine graft function. RESULTS The median age of patients was 15.9 (13.8;18.4) years, and the median follow-up time was 35.5 (20.0;62;0) months after transplantation. Nineteen patients (36.5%) were obese or overweight, 43 (83%) had hypertension or controlled hypertension, 23 (44%) had dyslipidemia, and 9 (17%) had hyperglycemia. Ten patients (19.2%) were diagnosed with metabolic syndrome. Twenty-eight patients (54%) had left ventricular hypertrophy. The prevalence of left ventricular hypertrophy was higher in patients with metabolic syndrome than in those without metabolic syndrome (90% vs. 45%, P = .014), whereas estimated glomerular filtration rate did not differ between the 2 groups. CONCLUSION Cardiometabolic risk factors are common in pediatric kidney transplant recipients. Approximately one-fifth of patients have metabolic syndrome, and left ventricular hypertrophy is much more common among patients with metabolic syndrome. However, there is no relationship between metabolic syndrome and graft dysfunction.
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Affiliation(s)
- Seha Kamil Saygılı
- Department of Pediatric Nephrology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Esra Karabağ Yılmaz
- Department of Pediatric Nephrology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Seçil Kezer
- Department of Pediatric Nephrology, İstanbul Medipol University Faculty of Medicine, İstanbul, Turkey
| | - Reyhan Dedeoğlu
- Department of Pediatric Cardiology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Şevval Kaplan Kılıç
- Department of Pediatrics, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Rumeysa Yasemin Çiçek
- Department of Pediatric Nephrology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Ruveyda Gülmez
- Department of Pediatric Nephrology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Ebru Burcu Demirgan
- Department of Pediatric Nephrology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Ayşe Ağbaş
- Department of Pediatric Nephrology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Mehmet Eliçevik
- Department of Pediatric Urology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Salim Çalışkan
- Department of Pediatric Nephrology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Nur Canpolat
- Department of Pediatric Nephrology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
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Yılmaz EK, Saygili S, Gulhan B, Canpolat N, Bayazıt AK, Kilic BD, Akıncı N, Benzer M, Goknar N, Tufan AK, Kalyoncu M, Nalcacioglu H, Tekcan D, Yıldız G, Agbas A, Nayır A, Topaloglu R, Caliskan S, Ozaltin F. A broad clinical spectrum of PLCε1-related kidney disease and intrafamilial variability. Pediatr Nephrol 2022; 37:1855-1866. [PMID: 35034193 DOI: 10.1007/s00467-021-05371-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The phenotypic and genotypic spectrum and kidney outcome of PLCε1-related kidney disease are not well known. We attempted to study 25 genetically confirmed cases of PLCε1-related kidney disease from 11 centers to expand the clinical spectrum and to determine the relationship between phenotypic and genotypic features, kidney outcome, and the impact of treatment on outcome. METHODS Data regarding demographics, clinical and laboratory characteristics, histopathological and genetic test results, and treatments were evaluated retrospectively. RESULTS Of 25 patients, 36% presented with isolated proteinuria, 28% with nephrotic syndrome, and 36% with chronic kidney disease stage 5. Twenty patients underwent kidney biopsy, 13 (65%) showed focal segmental glomerulosclerosis (FSGS), and 7 (35%) showed diffuse mesangial sclerosis (DMS). Of the mutations identified, 80% had non-missense, and 20% had missense; ten were novel. No clear genotype-phenotype correlation was observed; however, significant intrafamilial variations were observed in three families. Patients with isolated proteinuria had significantly better kidney survival than patients with nephrotic syndrome at onset (p = 0.0004). Patients with FSGS had significantly better kidney survival than patients with DMS (p = 0.007). Patients who presented with nephrotic syndrome did not respond to any immunosuppressive therapy; however, 4/9 children who presented with isolated proteinuria showed a decrease in proteinuria with steroids and/or calcineurin inhibitors. CONCLUSION PLCε1-related kidney disease may occur in a wide clinical spectrum, and genetic variations are not associated with clinical presentation or disease course. However, clinical presentation and histopathology appear to be important determinants for prognosis. Immunosuppressive medications in addition to angiotensin-converting enzyme inhibitors may be beneficial for selected patients. "A higher resolution version of the Graphical abstract is available as Supplementary information".
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Affiliation(s)
- Esra Karabağ Yılmaz
- Department of Pediatric Nephrology, Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Seha Saygili
- Department of Pediatric Nephrology, Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Bora Gulhan
- Department of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey
| | - Nur Canpolat
- Department of Pediatric Nephrology, Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Aysun Karabay Bayazıt
- Department of Pediatric Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | | | - Nurver Akıncı
- Department of Pediatric Nephrology, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Meryem Benzer
- Department of Pediatric Nephrology, Faculty of Medicine, Yeni Yuzyil University, Istanbul, Turkey
| | - Nilufer Goknar
- Department of Pediatric Nephrology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Asli Kavaz Tufan
- Department of Pediatric Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Mukaddes Kalyoncu
- Department of Pediatric Nephrology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Hulya Nalcacioglu
- Department of Pediatric Nephrology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Demet Tekcan
- Department of Pediatric Nephrology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Gizem Yıldız
- Department of Pediatric Nephrology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ayse Agbas
- Department of Pediatric Nephrology, Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Ahmet Nayır
- Department of Pediatric Nephrology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Rezan Topaloglu
- Department of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey
| | - Salim Caliskan
- Department of Pediatric Nephrology, Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Fatih Ozaltin
- Department of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.
- Nephrogenetics Laboratory, Department of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
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Döven SS, Tülpar S, Baştuğ F, Yıldırım ZNY, Yılmaz EK, Çiçek N, Küçük N, Çomak E, Yazıcıoğlu B, Nalçacıoğlu H, Delibaş A, Uysal B, Ağbaş A, Gemici A, Günay N, Ertan P, Bıyıklı N, Hacıhamdioğlu DÖ, Elmacı AM, Atikel YÖ, Delebe EÖÇ, Sever FL, Gökçe İ, Öner N, Akman S, Aksu B, Atmış B, Yel S, Yılmaz A, Çelik B, Dursun İ, Alpay H. A Nationwide Retrospective Study in Turkish Children With Nephrocalcinosis. Turk J Med Sci 2021; 51:2564-2569. [PMID: 34174796 DOI: 10.3906/sag-2103-347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/24/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Nephrocalcinosis (NC) is defined as calcium deposition in the kidney parenchyma and tubules. This study aims to determine the etiology, risk factors and follow-up results of patients with NC in Turkey. MATERIALS AND METHODS Patients diagnosed with NC in the Pediatric Nephrology Department Units of 19 centers from all geographical regions of Turkey over a 10-year period (2010?2019) were included in the study. The medical records from the centers were reviewed and demographic data, admission complaints, medical history, systemic and genetic disorders, risk factors for NC, treatment details and presence of NC after one year follow-up were recorded retrospectively. RESULTS The study sample included 195 patients (88 females, 107 males). The mean age at diagnosis was 39.44±47.25 (0.5?208) months; 82/190 patients (43.2%) were diagnosed incidentally; 46/195 patients (23.6%) had an underlying disease; idiopathic hypercalciuria was detected in 75/195 (38.4%) patients. The most common systemic diseases were distal renal tubular acidosis in 11/46 patients (23.9%), primary hyperoxaluria in 9/46 patients (19.6%) and Bartter syndrome in 7/46 patients (15.3%). After one year of follow-up, NC resolved in 56/159 patients (35.2%) and they all did not have an underlying systemic disease. CONCLUSION The most common presentation of NC was incidental. Distal renal tubular acidosis and primary hyperoxaluria were the main systemic diseases leading to NC, while hypercalciuria was the most common metabolic risk factor. Nephrocalcinosis was found to remain in most of the patients at a one year follow-up. It may resolve particularly in patients with no underlying systemic disease.
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Affiliation(s)
- Serra Sürmeli Döven
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Sebahat Tülpar
- Division of Pediatric Nephrology, Department of Pediatrics, Bakırköy Dr Sadi Konuk Education and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Funda Baştuğ
- Division of Pediatric Nephrology, Department of Pediatrics, Kayseri City Hospital, Kayseri, Turkey
| | - Zeynep Nagehan Yürük Yıldırım
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Esra Karabağ Yılmaz
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Cerrahpaşa University, İstanbul, Turkey
| | - Neslihan Çiçek
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Nuran Küçük
- Division of Pediatric Nephrology, Department of Pediatrics, Kartal Dr. Lütfi Kırdar City Hospital, University of Health Sciences, İstanbul, Turkey
| | - Elif Çomak
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Mediterranean University, Antalya, Turkey
| | - Burcu Yazıcıoğlu
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Hülya Nalçacıoğlu
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Ali Delibaş
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Berfin Uysal
- Division of Pediatric Nephrology, Department of Pediatrics, Bursa Dörtçelik Children Hospital, Bursa, Turkey
| | - Ayşe Ağbaş
- Division of Pediatric Nephrology, Department of Pediatrics, İstanbul Haseki Education and Research Hospital, İstanbul, Turkey
| | - Atilla Gemici
- Division of Pediatric Nephrology, Department of Pediatrics, Erzurum Education and Research Hospital, Erzurum, Turkey
| | - Neslihan Günay
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Pelin Ertan
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Neşe Bıyıklı
- Division of Pediatric Nephrology, Department of Pediatrics, Anadolu Medical Center, İstanbul, Turkey
| | - Duygu Övünç Hacıhamdioğlu
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Bahçeşehir University, İstanbul, Turkey
| | - Ahmet Midhat Elmacı
- Division of Pediatric Nephrology, Department of Pediatrics, Konya Dr Faruk Sukan Obstetrics and Children Hospital, Konya, Turkey
| | - Yeşim Özdemir Atikel
- Division of Pediatric Nephrology, Department of Pediatrics, Eskişehir City Hospital, Eskişehir, Turkey
| | - Emine Özlem Çam Delebe
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Fatma Lale Sever
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Cerrahpaşa University, İstanbul, Turkey
| | - İbrahim Gökçe
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Nimet Öner
- Division of Pediatric Nephrology, Department of Pediatrics, Kayseri City Hospital, Kayseri, Turkey
| | - Sema Akman
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Mediterranean University, Antalya, Turkey
| | - Bağdagül Aksu
- Division of Pediatric Nephrology, Department of Pediatrics, İstanbul Haseki Education and Research Hospital, İstanbul, Turkey
| | - Bahriye Atmış
- Division of Pediatric Nephrology, Department of Pediatrics, Erzurum Education and Research Hospital, Erzurum, Turkey
| | - Sibel Yel
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Alev Yılmaz
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Binnaz Çelik
- Division of Pediatric Nephrology, Department of Pediatrics, Kayseri City Hospital, Kayseri, Turkey
| | - İsmail Dursun
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Harika Alpay
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Marmara University, İstanbul, Turkey
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