Kidney is in Trouble with Mediators

The kidneys receive 20-25 % of cardiac output and play a main role in the control of cardiovascular homeostasis. It is an endocrine organ that regulates and produces many substances, scavenger particles and immune complexes. Cytokines, growth factors, reactive oxygen metabolites, bioactive lipids, proteases, vasoactive substances such as nitric oxide (NO), adrenomedullin (AM), urotensin-II (U-II), have been released in several diseases, and kidney is one of mostly affected organs in body. Some of these mediators act in a paracrine fashion while some act in autocrine. They play important roles in modulating the cardiovascular responses, renal hemodynamics, and probably in mediating the clinical and laboratory manifestations of several renal diseases. These mediators are like “a double edged sword.” While small amounts of them mediate many physiological events, little excess may cause the damage to the healthy cells. Many investigators have searched the role(s) of mediators in several diseases. However, the findings are mostly like the model of “chicken and egg”, and indistinguishable as to whether they are the causes of, or results of the diseases. We will discuss mainly the possible roles of NO, AM and U-II in children with several renal diseases and summarize what is known, and what must be known about these mediators

Renal Crisis in Children during Armed Conflict

Armed conflicts continue to occur in some regions of the globe, mostly in developing countries. These man-made disasters affect all segments of the population; however, some groups are more vulnerable and suffer more seriously from the unfavorable consequences of such conflicts. Among these, the pediatric population deserves special attention because they cannot protect themselves, and hence carry a higher threat of injuries and probability of death during conflicts. In addition, children who do survive the disaster are more prone to exploitation. Pediatric victims, including those who sustain acute kidney injury or those suffering from chronic kidney disease before armed conflicts, face higher risks of morbidity and mortality as a result of treatment problems, specifically limited dialysis options. Displaced children, forced to flee their homes as a result of armed conflicts, are also at risk for various health problems because they may not find ideal circumstances for disease treatment. Making preparations in anticipation of armed conflicts, such as disaster-relief scenarios and action plans, may be useful to decrease the death toll in these children, who are dependent on their caregivers for survival. Adopting principles of disaster nephrology may contribute to improved survival chances of pediatric kidney patients in chaotic circumstances. (C) 2020 Elsevier Inc. All rights reserved

Metabolic Syndrome Prevalence in Childhood Obesity and Assesment of Obesity Related Conditions

Childhood obesity is an important risk factor fort he development of metabolic syndrome. The aim of this study was to assess the childhood obesity and the related conditions, to investigate the frequency of insulin resistance and metabolic syndrome and the possible related factors with these. The medical records of patients those referring to the Well-Child Outpatient Clinic of Gaziantep University, School of Medicine for routine health check-ups (medical examination) or to be vaccination were reviewed. 100 obese children, diagnosed according the International Obesity Task Force, included into the study. Relative weight ratio between 120-140 was classified as obesity, and a ratio above 140 was considered as morbid obesity. The average age of patients (55 female, 45 male) was 11.2 ±3.8 (3-17) years. Thirty three of the subjects were children and, 67 of them were adolescents. The 48% percent of the subjects were morbidly obese. Morbid obesity was higher in adolescents and in patients with a consanguinity between parents. Insulin resistance was determined 6.7% in children, 47.5% in adolescents. Free T4 levels were lower in patients with insulin resistance (p= 0.000). There was a negative correlation between fT4 and weight, body mass index and HOMA levels (p [Med-Science 2012; 1(4.000): 271-82

A pilot study on treatment of infantile cystinosis with mesenchymal stem cells

Infantile cystinosis is a lysosomal storage disease leading to end stage kidney disease at early ages. There is no effective treatment and patients require long term dialysis or kidney transplant for survival. We present our experience on three affected children who received HLA matched allogeneic stem cell transplant. The protocol used was novel and designed to promote engraftment. The primary endpoint was safety for treatment related mortality or morbidity; All three children survived without serious adverse effects during extended follow up for over 4 years. Although we could not prove engraftment, all three children met secondary end point of sustained target functions over a 6 month follow-up. Further studies are warranted to further evaluate safety and efficacy of MSC treatment for infantile cystinosis

Waist to height ratio as a screening tool for identifying childhood obesity and associated factors

Kilic, Beltinge Demircioglu/0000-0001-9408-2139;WOS: 000502819400003PubMed: 31777510Objective: To investigate the prevalence of obesity and associated factors during childhood in Southeastern Turkey. Another objective was to determine the cut-off points of Waist to Height Ratio (WHtR) values for defining obesity/abdominal obesity. Methods: the community-based descriptive cross-sectional study was conducted in Gaziantep Turkey between November 2011 and December 2011 with 2718 primary school/high schools students aged 6-17 years. the SPSS 22.00 was used for the analysis of data. Results: the prevalence of overweight, obesity, abdominal obesity, was 13.2%, 4.2%, 26.4%, respectively. There was a reverse relationship between BMI/WC values and sleep durations (p= 1 hours in a day (p<0.05). Parental obesity status has an effective role on the WC/BMI values of children (p<0.05). the WHtR was a good predictor of diagnosis on obesity and abdominal obesity (AUC=0.928, p<0.0001; AUC=0.920, p<0.0001; respectively). the optimal cut-off values for obesity and abdominal obesity were detected as 0.5077, 0.4741, respectively. Conclusions: the WHtR can be used for diagnosis of obesity/abdominal obesity. Parental obesity, short sleep duration and computer use more than one hour per day are risk factors for the development of obesity in children and adolescents

Predictive value of the "Blood Pressure To Height Ratio" in diagnosis of prehypertension and hypertension during childhood in Southeastern Turkey

###EgeUn###Recently, a simple, accurate and non-age-related index "Systolic/Diastolic Blood Pressure to Height Ratio (SBPHR/DBPHR)" is started to try for diagnosing hypertension in childhood. The aim of this study was to investigate the possible cut-off points and diagnostic value of BPHR for identifying prehypertension/hypertension in children and adolescent, and evaluation of the relationship between body fat composition and BP. The community-based descriptive cross-sectional study was carried out with 2730 students in 17 elementary and high school. Total body fat composition was analyzed with bioelectrical impedance analysis method. The ROC curve analysis indicated that SBPHR/DBPHR was a good predictor for identifying hypertension (AUC = 0.937, p < 0.0001; AUC = 0.880, p < 0.0001, respectively). The optimal cut-off values of SBPHR/DBPHR for hypertension were detected as 0.7767, 0.4688; respectively. Although, optimal cut-off points of SBPHR/DBPHR were statistically significant for discriminating prehypertension (0.6849, p < 0.0001; 0.4425, p < 0.0001, respectively), but the diagnostic value was lower (AUC = 0.738; AUC = 0.751, respectively). An increase of 1 unit in total body fat (%) leads to an average 0.38/0.26 mmHg increase in SBP/DBP values (p < 0.001). The results suggest that BPHR may be a useful diagnostic marker for screening elevated BP in childhood, and SBP/DBP values affected by the increase in total body fat percentage in obese and non-obese children

Mannose Binding Lectin and Macrophage Migration Inhibitory Factor Gene Polymorphisms in Turkish Children with Cardiomyopathy: No Association with MBL2 Codon 54 A/B Genotype, but an Association between MIF -173 CC Genotype

<p>Myocardial inflammation is one of the commonest mechanisms in cardiomyopathy (CMP). Mannose binding lectin (MBL) is a key molecule in innate immunity, while macrophage migration inhibitory factor (MIF) is a constitutive element of the host defenses. We investigated the possible association between polymorphisms of MBL2 and MIF genes and CMP in Turkish children. Twenty-children with CMP and 30 healthy controls were analyzed for codon 54 A/B polymorphism in MBL, and -173 G/C polymorphism in MIF genes by using PCR-RFLP methods. No significant difference was found between genotypes and alleles of MBL2 gene codon 54 A/B polymorphism in patients and controls (p&#62;0.05). However, serum uric acid levels was found higher in dilated CMP patients with AA genotype. Frequency of MIF -173 CC genotype was significantly higher in patients (p&#60;0.05), and sodium levels were higher in patients with MIF -173 CC genotype. This study is the first to investigate the MBL and MIF gene polymorphisms in Turkish children with CMP. We conclude that CC genotype of MIF (-173) polymorphism may be a risk factor for CMP patients. However, further studies with larger samples are needed to address the exact role of this polymorphism in CMP.</p

Association of macrophage migration inhibitory factor and mannose-binding lectin-2 gene polymorphisms in acute rheumatic fever

Background: Macrophage migration inhibitory factor and mannose-binding lectin-2 play important roles in the pathogenesis of several acute and chronic inflammatory/autoimmune disorders. The aim of the study was to investigate any possible association between migration inhibitory factor and mannose-binding lectin-2 gene polymorphisms and acute rheumatic fever in children. Material and methods: A total of 38 unrelated children with acute rheumatic fever and 40 age- and sex-matched healthy controls were analysed for codon 54 A/B polymorphism in mannose-binding lectin-2 gene and -173 G/C polymorphism in migration inhibitory factor gene by using the polymerase chain reaction method. Results: Frequency of BB genotype of mannose-binding lectin-2 gene was higher in the patient group. Interestingly, children with acute rheumatic fever with AA genotype tended to have chorea compared with children with BB genotype. There was a statistically significant increase in frequency of the migration inhibitory factor -173 CC genotype in patients compared with the control subjects. Conclusion: The present study is the first to investigate the mannose-binding lectin-2gene polymorphism in children with acute rheumatic fever. BB genotype of mannose-binding lectin-2 (codon 54) and CC genotype of migration inhibitory factor (-173) may have a role in the immunoinflammatory process of acute rheumatic fever