Cardiometabolic risk factors in pediatric kidney transplant recipients

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

Nörojen mesane tanısıyla çocuk nefroloji polikliniğimizde takip edilen hastaların retrospektif değerlendirilmesi

GİRİŞ-AMAÇ: Çocuklarda nörojen mesane, konjenital veya edinilmiş patolojiler sonucu gelişebilen ve multidisipliner bir yaklaşımla takip edilmesi gereken bir patolojidir. Bu çalışmada, kliniğimizde nörojen mesane tanısıyla izlenen hastalar, retrospektif olarak incelenmiştir.GEREÇ-YÖNTEM: SBÜ Sultangazi Haseki Eğitim ve Araştırma Hastanesi Çocuk Nefroloji Polikliniği’nde Nisan 2017-Aralık 2019 tarihleri arasında takip edilmiş olan 49 hastanın poliklinik dosyası geriye dönük olarak incelendi.BULGULAR: Çalışma grubuna alınan toplam 49 hastanın başvuru sırasındaki yaş ortalaması 6,0±4,2 yıl (0,6-18 yıl) idi. Olguların 28’i kız (%57,1), 21’i erkekti (%42,9). Nörojen mesanenin nedeni 47 hastada spina bifidaydı. Bir hastamız posterior üretral valv, diğer hastamız da travmaya sekonder nörojen mesane ile izlenmekteydi. Geçirilmiş İYE sayısı 1,8±1,9 (0-7) idi. Hastalarımızın yaklaşık yarısı temiz aralıklı kateterizasyon yapmaktaydı. Antikolinerjik kullanım oranı %42,9, antibiyotik profilaksi kullanım oranı %38,8 idi. Üriner ultrasonografide 23 hastada normal bulgular, 12 hastada ise hidronefroz saptanmıştı. Ondört hastamız yürüyebiliyordu. Tetkik istenmiş olan 47 hastadan 12 tanesinde demir eksikliği anemisi tespit edilmiş ve tedavisi düzenlenmişti. Hastaların böbrek fonksiyonları ve ofis tansiyon ölçümleri normaldi.TARTIŞMA-SONUÇ: Çocuklarda nörojen mesanenin en sık karşılaşılan nedeni spina bifidadır. Serebral palsi, sakral agenezi, lumbosakral patolojiler, medulla spinalise bası yapan tümörler veya travmalar diğer nadir nedenlerdir. Özellikle meningomyoselli çocukların yenidoğan döneminden itibaren yakın izlemi, beslenme düzenlenmesi, konjenital anomaliler açısından tetkik edilip risklerin belirlenmesi ve koruyucu önlemlerin alınması gerekmektedir

Sjögren’s syndrome associated with systemic lupus erythematosus

Systemic lupus erythematosus and Sjögren’s syndrome are chronic auto- inflammatory disorders which can lead to serious organ damage. Although systemic lupus erythematosus and Sjögren’s syndrome were previously considered two forms of the same disease because of presence of clinical coexistence of these two conditions, the view that they are two different conditions with mutual characteristics has become prominent in recent years. In this paper, we reported a 16 year-old girl who was followed up with a diagnosis of Sjögren’s syndrome for six years and then was observed to have overlap of systemic lupus erythematosus. In the baseline, she did not have any clinical or serological evidence for systemic lupus erythematosus. After six year, massive proteinuria and serological findings developed and systemic lupus erythematosus nephritis was diagnosed by kidney biopsy. Currently, systemic lupus erythematosus and Sjögren’s syndrome cannot be differentiated definetely. We need more valuable diagnostic and classification criteria to differentiate these two important conditions