Kronik Böbrek Hastalığı Nedeniyle Takip Edilen Çocukların Ebeveynlerinin Mevsimsel Grip Aşısı ile İlgili Bilgi ve Görüşlerinin Değerlendirilmesi

Amaç: Bu çalışma ile çocuk nefroloji kliniğimizde kronik böbrek hastalığı (KBH) tanısı ile izlenen çocukların ebeveynlerinin mevsimsel grip aşısı hakkında bilgi, tutum ve görüşlerinin değerlendirilmesi amaçlanmıştır. Yöntem: Kasım 2019-Şubat 2020 tarihleri arasında Sağlık Bilimleri Üniversitesi, İzmir Tepecik Eğitim ve Araştırma Hastanesi, Çocuk Nefroloji Kliniği’ne başvuran 6 ay-18 yaş arası KBH tanılı hastaların gönüllü bir ebeveynine mevsimsel grip aşısı hakkında oluşturulan anket uygulandı ve anketi tamamlayanlar çalışmaya dahil edildi. Bulgular: Çalışmanın yapıldığı dönemde başvuran KBH tanılı 64 hastanın ebeveyni anketi tamamlayarak teslim etti. Mevsimsel grip aşısı hakkında 44 (%68,8) katılımcının aşı hakkında bilgi sahibi olduğu, 20 (%31,3) katılımcının ise daha önceden aşı ile ilgili herhangi bir bilgi edinmediği öğrenildi. Altmış dört katılımcıdan 10’unun (%15,6) KBH tanılı çocuğuna mevsimsel grip aşısı yaptırdığı görüldü. Çocuğuna aşı yaptırmamış olan 54 katılımcının en sık aşı yaptırmama gerekçesi ise aşı gerekliliği ile ilgili yeterli bilgilerinin olmaması idi. İmmünsüpresif ilaç kullanan ve kullanmayan hastaların oluşturduğu iki grup arasında aşı olma oranları arasında anlamlı fark saptanmadı. Her iki gruptan aşı ile ilgili bilgi sahibi olan katılımcıların bilgiye ulaşma yolları arasında ise istatistiksel olarak anlamlı fark saptandı. Hastalar; böbrek nakli olan ve diğer KBH tanılı olarak iki gruba sınıflandırıldığında; böbrek nakilli çocukların ebeveynlerinin bilgi sahibi olma oranları ve çocuklarının influenza açısından yüksek riskli olduğunun farkındalığı, diğer gruba göre anlamlı olarak yüksek saptandı. Sonuç: KBH tanılı ve mevsimsel grip aşısı endikasyonu olan çocuk hastalarda aşılanma oranı oldukça düşük olup; aileler influenza aşısı hakkında yeterli bilgi sahibi değildir. Bu nedenle çocuk nefroloji kliniklerinde hekimler tarafından ebeveynlere influenza enfeksiyonu ve aşısı hakkında yeterli bilgi verilmesi ile bu oranın artırılabileceği düşünülmektedirObjective: We evaluated the knowledge and opinions of the parents of children who were followed up with chronic kidney disease (CKD) in our pediatric nephrology clinic. Methods: A seasonal influenza vaccine questionnaire was administered to a voluntary parents of patients with CKD between the ages of 6 months and 18 who applied to the Pediatric Nephrology Department of Health Sciences University İzmir Tepecik Training and Research Hospital between November 2019 and February 2020, and those who completed the questionnaire were included in the study. Results: Parents of 64 patients diagnosed with CKD completed the questionnaire. It was learned that only 44 (68.8%) participants were informed about the vaccine. It was seen that 10 patients (15.6%) had seasonal flu vaccine. Fifty-four participants who had not yet had their child vaccinated were asked about their reasons for not getting vaccine. The most frequent answer was that families did not have sufficient information about the vaccine requirement. There was no significant difference in the rate of vaccination between the two groups of patients who were administered and did not use immunosuppressive drugs. A statistically significant difference was found between accessing the information about the participants who had knowledge about vaccine. The children diagnosed with CKD were classified into two groups as having kidney transplantation and other patients. The knowledge about influenza vaccine and the awareness of the high risk of their children of influenza infection to parents of children with kidney transplantation was significantly higher. Conclusion: The rate of vaccination against influenza is very low in pediatric patients with CKD. Therefore, it is thought that this ratio can be increased by increasing the giving of information about influenza infection and vaccination to parents by physicians in pediatric nephrology clinics

Comparison of infants and children with urolithiasis: a large case series.

We evaluated the demographic features, etiologic risk factors, treatment strategies, and outcome of the infants and children with urolithiasis (UL). A retrospective multicenter study was conducted including 23 Pediatric Nephrology centers in Turkey. The medical records of 2513 children with UL were reviewed. One thousand, three hundred and four boys and 1209 girls (1.1:1) were reported. The mean age at diagnosis was 39.5 +/- 35 months (0.4-231 months), and 1262 patients (50.2%) were in the first year of life (infants). Most of the cases with infantile UL were diagnosed incidentally. Microlithiasis (< 3 mm) was found in 794 patients (31.6%), and 64.5% of the patients with microlithiasis were infants. Stones were located in the pelvis-calyces in 63.2% (n: 1530) of the cases. The most common stone type was calcium oxalate (64.6%). Hypocitraturia was the most common metabolic risk factor (MRF) in children older than 12 months, but in infancy, hypercalciuria was more common. Fifty-five percent of the patients had received at least one medical treatment, mostly potassium citrate. At the end of a year's follow-up, most of the patients with microlithiasis (85%) showed spontaneous remission. The rate of spontaneous stone resolution in infants was higher than in children. Spontaneous remission rate was higher in cases with MRF ( - ) stones than in MRF ( +) stones. However, remission rate with medical treatment was higher in cases with MRF ( +) stones. This study represents the results of a large series of infants and children with UL and showed that there are several differences such as underlying metabolic and anatomic abnormalities, clinical course, and stone remission rates between infants and children with urinary stone disease

Characteristics and predictors of chronic kidney disease in children with myelomeningocele: a nationwide cohort study

Background: Myelomeningocele (MMC) is highly prevalent in developing countries, and MMC-related neurogenic bladder is an important cause of childhood chronic kidney disease (CKD). This nationwide study aimed to evaluate demographic and clinical features of pediatric patients with MMC in Turkey and risk factors associated with CKD stage 5. Methods: Data from children aged 0–19 years old, living with MMC in 2022, were retrospectively collected from 27 pediatric nephrology centers. Patients > 1 year of age without pre-existing kidney abnormalities were divided into five groups according to eGFR; CKD stages 1–5. Patients on dialysis, kidney transplant recipients, and those with eGFR < 15 ml/min/1.73 m2 but not on kidney replacement therapy at time of study constituted the CKD stage 5 group. Results: A total of 911 (57.8% female) patients were enrolled, most of whom were expectantly managed. Stages 1–4 CKD were found in 34.3%, 4.2%, 4.1%, and 2.4%, respectively. CKD stage 5 was observed in 5.3% of patients at median 13 years old (range 2–18 years). Current age, age at first abnormal DMSA scan, moderate-to-severe trabeculated bladder on US and/or VCUG, and VUR history were independent risk factors for development of CKD stage 5 (OR 0.752; 95%; CI 0.658–0.859; p < 0.001; OR 1.187; 95% CI 1.031–1.367; p = 0.017; OR 10.031; 95% CI 2.210–45.544; p = 0.003; OR 2.722; 95% CI 1.215–6.102; p = 0.015, respectively). Only eight CKD stage 5 patients underwent surgery related to a hostile bladder between 1 and 15 years old. Conclusion: MMC-related CKD is common in childhood in Turkey. A proactive approach to neurogenic bladder management and early protective surgery in selected cases where conservative treatment has failed should be implemented to prevent progressive kidney failure in the pediatric MMC population in our country. Graphical abstract: [Figure not available: see fulltext.