Most Difficult Questions in Patients with Primary Enuresis Nocturna: Correct treatment? Right time?

Aim:In this study, we aimed to evaluate the efficacy of combined desmopressin and behavior therapy in patients with monosymptomatic enuresis nocturna who had previously received short-term medical treatment retrospectively.Materials and Methods: The patients who were diagnosed as monosymptomatic enuresis nocturna by pediatricians were treated with desmopressin melt treatment for 1 month and 3 months and received complete or partial response. Desmopressin treatment and behavioral treatment were administered together for 6 months.Results: The mean age of the patients was 11 ± 2.1 (minimum 6, maximum 17 years). Of the 148 patients whose desmopressin + behavior therapy was completed for 6 months, 121 (%81,70) had complete dryness and 12 (%8,10) had partial response. Fifteen (%10.20) patients were evaluated as unresponsive. Recurrence was observed in 26 (%17,50) patients within 3 months after the end of treatment. 16 patients with relapse and unresponsive to treatment were <12 years of age.Conclusion: Successful completion of treatment in enuresis nocturna and the addition of behavioral treatment to medical treatment is very important to reduce the risk of recurrence. The underlying neurological immaturity significantly affects the chances of success of the treatment

COVID-19 in pediatric nephrology centers in Turkey

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

COVID-19 in pediatric nephrology centers in Turkey

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