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Background Peritoneal dialysis (PD) is the most common kidney replacement therapy in children. Complications associated with PD affect treatment success and sustainability. The aim of this study was to investigate the frequency of PD-related non-infectious complications and the predisposing factors. Methods Retrospective data from 11 centers in Turkey between 1998 and 2018 was collected. Non-infectious complications of peritoneal dialysis (NICPD), except metabolic ones, in pediatric patients with regular follow-up of at least 3 months were evaluated. Results A total of 275 patients were included. The median age at onset of PD and median duration of PD were 9.1 (IQR, 2.5-13.2) and 7.6 (IQR, 2.8-11.9) years, respectively. A total of 159 (57.8%) patients encountered 302 NICPD within the observation period of 862 patient-years. The most common NIPCD was catheter dysfunction (n = 71, 23.5%). At least one catheter revision was performed in 77 patients (28.0%). Longer PD duration and presence of swan neck tunnel were associated with the development of NICPD (OR 1.191; 95% CI 1.079-1.315, p = 0.001 and OR 1.580; 95% CI 0.660-0.883, p = 0.048, respectively). Peritoneal dialysis was discontinued in 145 patients; 46 of whom (16.7%) switched to hemodialysis. The frequency of patients who were transferred to hemodialysis due to NICPD was 15.2%. Conclusions Peritoneal dialysis-related non-infectious complications may lead to discontinuation of therapy. Presence of swan neck tunnel and long duration of PD increased the rate of NICPD. Careful monitoring of patients is necessary to ensure that PD treatment can be maintained safely., Author(s): Gulsah Kaya Aksoy [sup.1] , Mesiha Ekim [sup.2] , Sevcan A. Bakkaloglu [sup.3] , Seda Coskun [sup.4] , Ali Delibas [sup.5] , Seçil Conkar [sup.6] , Dilek Yilmaz [sup.7] [...]

Background An increase in the number of circulating endothelial cells (CEC) indicates endothelial damage and the risk of cardiovascular disease. The aim of our study was to investigate the association of CEC with various clinical parameters in pediatric renal transplant recipients. Methods CEC, defined as [CD45.sup.-] [CD146.sup.+], were enumerated by flow cytometry from the peripheral blood of 50 pediatric renal transplant recipients and 20 healthy controls. Clinical parameters, including renal function tests, fasting blood glucose, serum cholesterol and triglyceride, cyclosporine A (CsA) (trough and 2nd-hour) and tacrolimus (tac) trough blood levels and their association with CEC numbers were analyzed. Results CEC numbers of patients were higher than those of controls (respectively, 128±89 cells/ml (42-468 cells/ml), 82±33 cells/ml (32-137 cells/ml), p = 0.024). There was a statistically significant negative correlation between CEC numbers and glomerular filtration rate (GFR) (r = -0.300, p = 0.012). There was also a statistically positive association between CEC numbers and transplant duration as well as cyclosporine trough level (respectively, r = 0.397, p = 0.004, r=0.714,p =0.004). CEC numbers in patients on tac and CsA were similar (p =0.716). Conclusions Our results demonstrate that renal transplant recipients with high CsA trough blood level, longer transplant duration, and lower GFR, are at greater risk of developing endothelial damage. Keywords CD146 * Chronic kidney disease (CKD) * Cardiovascular disease (CVD) * Pediatric kidney transplantation * Endothelial damage * Cyclosporine, Introduction Life expectancy of renal transplant recipients is shorter than the general population due to cardiovascular diseases (CVD) [1]. The risk factors for CVD in patients with chronic kidney disease [...]

Author(s): Mustafa Koyun [sup.1] , Elif Çomak [sup.1] , Sema Akman [sup.1] Author Affiliations: (Aff1) 0000 0001 0428 6825, grid.29906.34, School of Medicine, Department of Pediatrics, Division of Pediatric Nephrology, [...]

Objective: Lower urinary tract dysfunction is a wide clinical spectrum and according to the International Children's Continence Society, lower urinary tract dysfunction contains overactive bladder, voiding postponement, underactive bladder, infrequent voiding, extraordinary daytime only urinary frequency, vaginal reflux, bladder neck dysfunction, and giggle incontinence. Biofeedback is a non-invasive therapy that can be applied easily and aims to activate relevant pelvic wall muscles for normal bowel and bladder functions. This study aimed to evaluate the efficacy of biofeedback treatment in children with lower urinary tract dysfunction. Material and Methods: Twenty-nine patients who were diagnosed with lower urinary tract dysfunction and did not respond to standard therapy were included in the study. Biofeedback therapy was applied to these patients for 8 weeks. Results: After animation biofeedback treatment, daytime symptoms improved in 13 patients (44.8%), and nighttime enuresis improved in two (6.8%) patients. Although 5 patients with constipation completely improved, there was no improvement in patients with encopresis. There was a decrease but not a complete improvement in complaints of six patients (20.7%). Mean urinary incontinence symptom score which was 16.19±7.69 before biofeedback treatment decreased to 9.52±6.4 after the treatment, with a statistically significant difference (p<0.001). Conclusion: It was suggested that biofeedback treatment can be considered as a suitable alternative in children with dysfunctional urination who do not respond to standard treatment. [ABSTRACT FROM AUTHOR]

Distal renal tubular acidosis (DRTA) is characterized by tubular defects in urinary acidification and hyperchloremic metabolic acidosis, hypokalemia, hypercalciuria, hypocitraturia, nephrocalcinosis and nephrolithiasis. Mutations in ATP6V1B1 cause DRTA associated with sensorineural hearing loss. The objective of this multicenter study is to screen DRTA patients with sensorineural hearing loss for ATP6V1B1 gene mutations and present genotype/phenotype correlation. Clinical data in five unrelated consanguineous families with DRTA and hearing loss were obtained in Turkey. For mutation screening, all coding exons of ATP6V1B1 were PCR-amplified and sequenced from genomic DNA. In our cohort of five families, there were four different homozygous ATP6V1B1 mutations in affected individuals: c.91C>T (p.R31X), c.232G>A (p.G78R), c.497delC (p.T166RfsX9) and c.1155dupC (p.I386HfsX56). Our study shows that rare and family-specific variants in ATP6V1B1 are responsible for DRTA and sensorineural hearing loss syndrome in Turkey. While firm genotype-phenotype correlations are not available, detailed clinical and molecular analyses provide data to be used in genetic counseling. [ABSTRACT FROM AUTHOR]

Objectives: We sought to evaluate the prevalence and confounding clinical variables of hyperuricemia in pediatric kidney transplant patients., Materials and Methods: We retrospectively evaluated the medical records of 151 pediatric renal transplant recipients who received their grafts at Akdeniz University Medical Faculty in Antalya, Turkey, with a follow-up longer than 6 months. This retrospective, single-center study included 117 pediatric renal transplant recipients, after we had excluded the patients with changes in immunosuppressive treatment and graft loss, who were receiving therapy with allopurinol and furosemide. Patient information and laboratory data were obtained from patient charts and an electronic hospital database., Results: Mean uric acid levels of patients were 311 ± 74 μmol/L, and 24 of all of the patients (20%) had high uric acid levels. Fifteen patients taking tacrolimus (16%), and 9 of patients taking cyclosporine (39%) had hyperuricemia. The hyperuricemia rate of patients taking cyclosporine was significantly higher than it was for those patients taking tacrolimus (P = .014). Mean levels of uric acid in patients taking cyclosporine were higher than those of patients taking tacrolimus (344 ± 62 μmol/L and 303 ± 75 μmol/L; P = .006). There was a significant positive correlation between mean uric acid concentrations, and both serum creatinine (P = .000; r=0.487) and cystatin C (P = .000; r=0.433). There was negative correlation between mean uric acid concentration and estimated glomerular filtration rate (P = .000; r=-0.417). Mean uric acid levels of patients with intact graft function (estimated glomerular filtration rate ≥ 60 mL/min/1.73 m²) was lower than the patients with a low estimated glomerular filtration rate (291 ± 67 μmol/L and 353 ± 71 μmol/L; P = .000). Mean uric acid level of patients with normal body mass index was significantly lower than that of patients who were obese-overweight (301 ± 64 μmol/L vs 343 ± 94 μmol/L; P = .045)., Conclusions: We found 20% of our patient group had high uric acid levels. We also found that lower glomerular filtration rate, higher serum creatinine, cystatin c, obesity, and being overweight were risk factors for hyperuricemia in pediatric renal transplant recipients.