Publications by authors named "Ipek Kaplan Bulut"
Article Synopsis
- The study examines how various clinical, laboratory, and personal factors influence the choice and timing of kidney replacement therapy (KRT) among pediatric patients with chronic kidney disease (CKD).
- Researchers analyzed a cohort of 695 children aged 6 to 17 to identify what factors lead to either starting dialysis or receiving preemptive transplantation.
- Key findings show that kidney function decline, disease type, and other health indicators like blood pressure and hemoglobin levels significantly affect KRT decisions, with notable variations between different medical centers.
Background: Despite significant cardiovascular (CV) morbidity in children on dialysis and after kidney transplantation, data on the evolution of CV damage in children with chronic kidney disease (CKD) approaching kidney replacement therapy (KRT) is unknown.
Methods: The burden, progression, and predictors of CV damage before KRT onset were explored in two prospective multicenter cohorts from Europe and Canada: Cardiovascular Comorbidity in Children with CKD (4C) and Haemodiafiltration, Heart and Height (3H) studies, conducted from 2009-19 and 2013-16, respectively. CV damage and risk factors were evaluated (i) cross sectionally at KRT-start (n = 248), and (ii) longitudinally over the 2-years preceding KRT start (n = 157; 331 patient-visits).
Background: Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children.
Methods: The study involved children included in the EurAKId registry (NCT02960867), who underwent CKRT treatment.
Background: Dyslipidemia is an important and modifiable risk factor for CVD in children with CKD.
Methods: In a cross-sectional study of baseline serum lipid levels in a large prospective cohort study of children with stage 3-5 (predialysis) CKD, frequencies of abnormal lipid levels and types of dyslipidemia were analyzed in the entire cohort and in subpopulations defined by fasting status or by the presence of nephrotic range proteinuria. Associated clinical and laboratory characteristics were determined by multivariable linear regression analysis.
Objective: Immunoglobulin-A vasculitis (IgAV) is an inflammatory disease that affects small blood vessels. This study was performed to identify an association between protein tyrosine phosphatase non-receptor type 22 (PTPN22) + 788G > A (rs33996649), transforming growth factor-beta (TGF-β) -509C > T (rs18004069), interleukin 1-beta (IL-1β) -511C > T (rs16944), interleukin 5 (IL-5) -746C/T (rs2069812), and angiotensin-converting enzyme (ACE) I/D (rs4646994) gene polymorphisms, susceptibility to IgAV, as well as the mRNA levels of IL-1β, IL-1β, and TGF-β.
Method: A total of 53 patients with IgAV and 50 healthy controls were enrolled.
Article Synopsis
- The study focuses on urinary tract infections (UTIs) in children and investigates the potential use of soluble Toll-like receptors (sTLR4, sTLR5) and interleukin 8 (IL-8) as biomarkers for diagnosing UTIs.
- It involved 520 children, including those with UTIs, non-UTI infections, and healthy controls, measuring urine and serum levels of the biomarkers before and after treatment.
- Results show that urine sTLR4 levels are higher in UTI patients, with a cut-off level identified to predict UTIs, especially higher in cases of pyelonephritis compared to cystitis, and decreasing post-treatment.
Background: We assessed the effect of blood pressure (BP) control on left ventricular mass index (LVMI) and left ventricular hypertrophy (LVH).
Methods: Ninety-six patients (64 males) ≥9 months post-kidney transplantation from the 4C-T (Cardiovascular Comorbidity in Children with Chronic Kidney Disease and Transplantation) study were analyzed longitudinally (mean follow-up, 2.6±1.
Background: Kidney transplantation is the predominant treatment option in patients with end-stage renal disease. The aim of this study was to evaluate the effect of the presence of a psychiatric disorder on the quality of life in children and adolescents after kidney transplantation.
Methods: A total of 43 patients aged 6 to 18 years were included in the study.
Background: Childhood-onset chronic kidney disease is a progressive condition that can have a major effect on life expectancy and quality. We evaluated the usefulness of the kidney tubular cell stress marker urinary Dickkopf-related protein 3 (DKK3) in determining the short-term risk of chronic kidney disease progression in children and identifying those who will benefit from specific nephroprotective interventions.
Methods: In this observational cohort study, we assessed the association between urinary DKK3 and the combined kidney endpoint (ie, the composite of 50% reduction of the estimated glomerular filtration rate [eGFR] or progression to end-stage kidney disease) or the risk of kidney replacement therapy (ie, dialysis or transplantation), and the interaction of the combined kidney endpoint with intensified blood pressure reduction in the randomised controlled ESCAPE trial.
Background: Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic immune-inflammation index (SII = N × P/L), and neutrophil percentage-albumin ratio (NPAR) have become accepted markers of inflammation in recent years. These indices are used as indicators of disease activity, mortality, and morbidity in many diseases. This study evaluated the relationship between inflammatory indices and graft function in pediatric kidney transplant recipients.
View Article and Find Full Text PDFBackground: The negative effects of pretransplant obesity and post-transplant body mass index (BMI) increase on graft survival have been reported in recent years. The aim of this study is to evaluate the effects of BMI changes on post-transplant graft function, lipid profile, and blood pressure.
Methods: The study included 133 pediatric patients transplanted between 1994 and 2019 in Ege University.
Background: We aimed to compare the acute kidney injury (AKI) incidence in pediatric septic shock patients according to the three different classifications.
Methods: We analyzed retrospectively 52 patients with severe sepsis between January 2019 and December 2019.
Results: While 21 patients have been diagnosed with SA-AKI according to the pRIFLE criteria, 20 children have been diagnosed according to the AKIN criteria, and 21 children have been diagnosed according to the KDIGO criteria.
Background: The "HDF-Heart-Height" study showed that haemodiafiltration (HDF) is associated with improved growth compared to conventional haemodialysis (HD). We report a post-hoc analysis of this study assessing the effect of extracorporeal dialysis therapies on nutritional indices.
Methods: 107 children were included in the baseline cross-sectional analysis, of whom 79 (43 HD, 36 HDF) completed the 12-month follow-up.
Article Synopsis
- A new study looked at a special urine test called uHSP70 to help tell if kids have a urinary tract infection (UTI) instead of just using regular tests that might not be very reliable.
- The study involved 802 kids and found that uHSP70 levels were much higher in kids with UTI compared to those with other infections or who were healthy.
- Using uHSP70 could help doctors correctly diagnose UTIs and might stop about 80% of kids from getting unnecessary antibiotics.
Introduction: We searched for risk factors of cardiovascular assessment among children on dialysis.
Methods: This is a cross-sectional study of cardiovascular assessment of all patients on dialysis at Ege University Children's Hospital. Pediatric patients between the ages of 6 and 21 who were on HD and peritoneal dialysis treatment were included in the study.
Background: Acute kidney injury (AKI), particularly that requiring dialysis, is a severe complication in hospitalized children that is associated with high morbidity and mortality. A prospective European AKI registry (EurAKId registry, NCT02960867) was created to describe the epidemiology and outcomes of paediatric patients treated with acute dialysis.
Methods: Children were recruited who were between 0 and 18 years of age and were treated both in and outside the paediatric intensive care unit (PICU) with peritoneal dialysis (PD), haemodialysis (HD) or continuous kidney replacement therapy (CKRT) for AKI or metabolic derangement, fluid overload (FO), sepsis or respiratory distress.
Hemodiafiltration Is Associated With Reduced Inflammation and Increased Bone Formation Compared With Conventional Hemodialysis in Children: The HDF, Hearts and Heights (3H) Study.
Kidney Int Rep
September 2021
Background: Patients on dialysis have a high burden of bone-related comorbidities, including fractures. We report a analysis of the prospective cohort study HDF, Hearts and Heights (3H) to determine the prevalence and risk factors for chronic kidney disease-related bone disease in children on hemodiafiltration (HDF) and conventional hemodialysis (HD).
Methods: The baseline cross-sectional analysis included 144 children, of which 103 (61 HD, 42 HDF) completed 12-month follow-up.
Background: Hypertension is prevalent in children on dialysis and associated with cardiovascular disease. We studied the blood pressure (BP) trends and the evolution of BP over 1 year in children on conventional hemodialysis (HD) vs. hemodiafiltration (HDF).
View Article and Find Full Text PDFBackground: Uraemic cardiac remodelling is associated with vitamin D and Klotho deficiency, elevated fibroblast growth factor 23 (FGF23) and activation of the renin-angiotensin system (RAS). The cardioprotective properties of active vitamin D analogues in this setting are unclear.
Methods: In rats with 5/6 nephrectomy (5/6Nx) treated with calcitriol, the cardiac phenotype and local RAS activation were investigated compared with controls.
The uremic toxins indoxyl sulfate (IS) and p-cresyl sulfate (pCS) accumulate in patients with chronic kidney disease (CKD) as a consequence of altered gut microbiota metabolism and a decline in renal excretion. Despite of solid experimental evidence for nephrotoxic effects, the impact of uremic toxins on the progression of CKD has not been investigated in representative patient cohorts. In this analysis, IS and pCS serum concentrations were measured in 604 pediatric participants (mean eGFR of 27 ± 11 ml/min/1.
View Article and Find Full Text PDFIntroduction: In this study,we investigated the presence of cytomegalovirus (CMV) infection in kidney transplanted children and its effect on kidney dysfunction.
Material And Methods: One hundred thirty-five pediatric renal transplant patients were included in this study. The presence of CMV infection, CMV risk status, and other clinical features of the patients were evaluated retrospectively.
Background And Objectives: Although renin-angiotensin-aldosterone system inhibition (RAASi) is a cornerstone in the treatment of children with CKD, it is sometimes discontinued when kidney function declines. We studied the reasons of RAASi discontinuation and associations between RAASi discontinuation and important risk markers of CKD progression and on eGFR decline in the Cardiovascular Comorbidity in Children with CKD study.
Design, Setting, Participants, & Measurements: In this study, 69 children with CKD (67% male, mean age 13.
Membranous nephropathy in a child with crescentic glomerulonephritis: Coincidence or comorbidity?
Saudi J Kidney Dis Transpl
April 2020
Rapidly progressive glomerulonephritis (RPGN) is rare syndrome in children, characterized by clinical features of glomerulonephritis and rapid loss of renal function, and is associated with crescentic glomerulonephritis. Primary membranous nephropathy (MN) is an immune-complex-mediated cause of the adult nephrotic syndrome but occurs less frequently in children. RPGN is rarely observed in adults with primary MN.
View Article and Find Full Text PDFArticle Synopsis
- Cardiovascular disease is a major health concern for children with chronic kidney disease (CKD), with gut-derived toxins increasing as kidney function worsens, affecting heart health.
- The study measured levels of indoxyl sulfate (IS) and p-cresyl sulfate (pCS) in children's blood and examined their relationship with vascular health indicators, such as carotid thickness and pulse wave velocity.
- Results showed that higher serum levels of these toxins were linked to decreased kidney function, and only indoxyl sulfate (IS) was meaningfully associated with cardiovascular disease markers over time in the CKD pediatric population.
Introduction: and Aim. End-stage renal disease owing to structural urologic anomalies is frequent in the pediatric population. Impaired bladder function is thought to have a negative effect on graft function and survival.
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