Publications by authors named "Gulhan Bora"

Article Synopsis
  • Short bowel syndrome (SBS) results from significant small intestine removal, leading to issues like diarrhea and difficulties with drug absorption, which can complicate kidney transplantation.* -
  • A case study is presented of an 18-month-old boy with SBS who successfully underwent kidney transplantation and maintained good health for four years without needing intestinal surgery.* -
  • The immunosuppressive treatment using prednisolone, tacrolimus, and mycophenolate mofetil worked effectively in this patient, suggesting these drugs are viable options for others with SBS undergoing transplantation.*
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Article Synopsis
  • Fanconi anemia (FA) is a genetic condition leading to bone marrow failure, and while hematopoietic stem cell transplantation (HSCT) can provide long-term survival, patients face ongoing health challenges after treatment.
  • A study of 36 FA patients who had undergone HSCT showed significant long-term issues, including hormonal imbalances, growth impairments, and signs of metabolic syndrome, highlighting the need for better follow-up care guidelines.
  • Key findings included gonadal dysfunction in 35% of patients, pulmonary function issues in nearly half, and a small percentage developing secondary cancers, emphasizing the importance of addressing late effects of HSCT in FA survivors.
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Background/objectives: Eculizumab is a first-line treatment for atypical hemolytic uremic syndrome (aHUS), and patients undergoing eculizumab therapy may become more susceptible to infection caused by (). While meningococcal vaccination is required for patients undergoing eculizumab therapy, there is limited knowledge about meningococcal carriage in children with aHUS. We aimed to evaluate (1) the prevalence of carriage, (2) serogroup distribution, and (3) the immunization status of children undergoing eculizumab treatment for aHUS.

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Background: Complement 3 glomerulopathy (C3G) and immune complex membranoproliferative glomerulonephritis (IC-MPGN) are ultra-rare chronic kidney diseases with an overall poor prognosis, with approximately 40-50% of patients progressing to kidney failure within 10 years of diagnosis. C3G is characterized by a high rate of disease recurrence in the transplanted kidney. However, there is a lack of published data on clinical outcomes in the pediatric population following transplantation.

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Background: Following the pandemic of COVID-19, the main focus has been on COVID-19 vaccines and herd immunity. Although the safety of the COVID-19 vaccines has been shown in clinical trials, children with chronic diseases were not included. We investigated the side effect profile and safety of the COVID-19 vaccines in adolescents with kidney disease.

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Introduction: Calcineurin inhibitors (CNIs) are widely used in transplantation. Although CNI-related hyperkalemia is common (10%-60.6%), the underlying pathogenetic mechanism is not well-elucidated and may lead to dose adjustment or treatment withdrawal.

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Background: Atypical hemolytic uremic syndrome (aHUS) is a rare, mostly complement-mediated thrombotic microangiopathy. The majority of patients are infants. In contrast to infantile-onset aHUS, the clinical and genetic characteristics of adolescence-onset aHUS have not been sufficiently addressed to date.

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Article Synopsis
  • HNF1B mutations are a leading genetic cause of congenital kidney and urinary tract abnormalities, prompting a study of 16 pediatric patients to better understand its clinical and genetic features.
  • The research found that 81.3% of patients had prenatal kidney abnormalities, with kidney cysts being the most prevalent, and identified missense variants as the most common genetic issues linked to these conditions.
  • The study suggests that patients with missense variants are at a greater risk for chronic kidney disease (CKD), while urinary system abnormalities like vesicoureteral reflux are also common in this group.
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Classical clinical triad of hemolytic uremic syndrome (HUS) is microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury associated with endothelial cell injury. Several situations, including infections, medications, malignancies, and transplantation can trigger endothelial damage. On the HUS spectrum, atypical hemolytic uremic syndrome (aHUS) deserves special attention in pediatric patients, as it can cause endstage kidney disease and mortality.

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  • Two devastating earthquakes in Türkiye on February 6, 2023, resulted in significant injuries to 903 children, with a focus on crush syndrome-related acute kidney injury (Crush-AKI) and mortality.
  • The study tracked various factors, including the time under rubble, treatment protocols, and patient outcomes, revealing that Crush-AKI developed in 36% of the patients, and over half required dialysis.
  • Key findings included that serum levels of creatine phosphokinase above 20,950 U/L and inadequate initial intravenous fluid volume were linked to Crush-AKI, and most deaths occurred among those with Crush-AKI within the first four days of admission.
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Background: COVID-19 is known to have a mild course in children, however more data on pediatric chronic kidney disease (CKD) is needed. We aimed to assess the incidence and severity of COVID-19 in pediatric CKD patients.

Methods: A questionnaire including demographics, COVID-19 history, symptoms, and vaccination status was applied to patients with CKD.

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Cystinosis is an autosomal recessive disease caused by mutations in the CTNS gene encoding a protein called cystinosine, which is a lysosomal cystine transporter. Disease-causing mutations lead to accumulation of cystine crystals in the lysosomes, thereby causing dysfunction of vital organs. Determination of the increased leukocyte cystine level is one of the most used methods for diagnosis.

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Background: Data on the characteristics of acute kidney injury (AKI) in pediatric COVID-19 and MIS-C are limited. We aimed to define the frequency, associated factors and early outcome of AKI in moderate, severe or critical COVID-19 and MIS-C; and to present a tertiary referral center experience from Türkiye.

Methods: Hospitalized patients ≤ 18 years of age with confirmed COVID-19 or MIS-C at İhsan Doğramacı Children's Hospital, Hacettepe University, between March 2020-December 2021 were enrolled.

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Background: We aimed to detect complications and associated risk factors in patients with renal scarring (RS) secondary to recurrent urinary tract infections (UTI).

Methods: Fifty patients with RS were compared with 25 patients without RS by means of, serum creatinine, 24- hour urinary creatinine clearance, and 24-hour urinary albumin levels. Office blood pressure (BP) examination and ambulatory BP monitoring (ABPM) were also performed.

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Background: Café-au-lait skin macules, Cushing syndrome (CS), hyperthyroidism, and liver and cardiac dysfunction are presenting features of neonatal McCune-Albright syndrome (MAS), CS being the rarest endocrine feature. Although spontaneous resolution of hypercortisolism has been reported, outcome is usually unfavorable. While a unified approach to diagnosis, treatment, and follow-up is lacking, herein successful treatment and long-term follow-up of a rare case is presented.

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Background: Alport syndrome (AS) is characterized by progressive kidney disease. There is increasing evidence that renin-angiotensin-aldosterone system (RAAS) inhibition delays chronic kidney disease (CKD) while the effectiveness of immunosuppressive (IS) therapy in AS is still uncertain. In this study, we aimed to analyze the outcomes of pediatric patients with X-linked AS (XLAS) who received RAAS inhibitors and IS therapy.

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Article Synopsis
  • The study analyzed clinical characteristics and long-term outcomes of children under 15 kg who underwent different types of acute kidney support therapy: hemodialysis (HD), peritoneal dialysis (PD), and continuous kidney replacement therapy (CKRT).
  • Out of 109 patients, 64% died shortly after treatment, with survival correlating with lower use of vasopressors and absence of mechanical ventilation.
  • Follow-up evaluations showed a significant percentage of survivors had kidney risk factors, demonstrating the importance of extended monitoring for patients following acute kidney treatment.
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Introduction: Distal renal tubular acidosis (dRTA) is a disease that may develop either primarily or secondarily, resulting from urinary acidification defects in distal tubules. Hearing loss may accompany primary forms of dRTA. This study aims to determine the characteristics of hearing loss due to different gene mutations in patients with dRTA.

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Cystinosis is a rare, devastating hereditary disease secondary to recessive gene mutations. The most commonly used diagnostic method is confirmation of an elevated leukocyte cystine level; however, this method is expensive and difficult to perform. This study aimed to identify candidate biomarkers for the diagnosis and follow-up of cystinosis based on multiomics studies.

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Introduction: Autosomal recessive polycystic kidney disease (ARPKD) is associated with pathogenic variants in the PKHD1 gene. Autosomal dominant polycystic kidney disease (ADPKD) is mainly associated with pathogenic variants in PKD1 or PKD2. The present study aimed to identify the clinical and genetic features of Turkish pediatric ARPKD and ADPKD patients.

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This paper studies the radionuclide (Cs, Ra, Th, K) activity concentrations and gross radioactivities in waters and sediments of Lake Van, which is the third largest closed lake (with no natural or artificial outlet) within the Earth. The physico-chemical parameters were measured and evaluated in the lake waters. The mean gross α activities in surface, middle and bottom waters are 0.

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