Evaluation of Etiological Causes in Children with Symptomatic Hematuria

Hematuria is an important and common symptom of urinary system pathologies in children, and careful evaluation is required for its definitive diagnosis. In this study, we aimed to determine the demographic and clinical characteristics and etiological causes of patients who applied to our pediatric nephrology clinic with hematuria. In this study, the record of 434 patients who were followed up in our clinic for macroscopic and/or microscopic hematuria were evaluated retrospectively. Demographic data, clinical findings, laboratory and imaging examinations and final diagnosis of the patients were recorded. Out of 434 patients with hematuria, 239 (55%) were male and 195 (45%) were female. Of the patients, 291 (67%) had macroscopic hematuria and 83 (19.1%) had glomerular hematuria. Non-glomerular causes were found in 80.9%, with a significantly higher rate. Most of the causes of non-glomerular hematuria were urinary tract infection and renal stones. Acute poststreptococcal glomerulonephritis (APSGN) was found to be responsible for the majority of glomerular diseases. This study shows that most of the pathologies that may cause hematuria can be detected with a detailed history, careful physical examination and simple laboratory tests

Cardiac functions and pericardial thickness changes in familial Mediterranean fever patients

Abstract Background The goal of the study is to ascertain how the pericardium and heart functions alter in patients with familial Mediterranean fever (FMF) both during the acute phase and the period of subclinical inflammation. Methods During the study, 99 patients diagnosed with FMF (35 of whom were in an FMF attack period) were recruited to this study, and 24 completely healthy children in the same age group—who did not have FMF and had not any cardiac condition that applied to visit the pediatric cardiology outpatient clinic for routine follow-up—were included as the control group. Results In patients with FMF, there was no discernible relationship between genetic abnormalities and pericardial thickness (p > 0.05). A significant difference was not observed in the diastolic and systolic cardiac function values between the control group and the FMF patients, with the exception of the parameters related to ejection time (ET), contraction time (IVCT), and relaxation time (IVRT). It was observed that pericardial thickness was greater in FMF patients than in study participants who did not have FMF, and this difference is statistically significant (p < 0.05). Conclusions It was determined that the effects of cardiac inflammation continued in children with FMF, even if they were asymptomatic. Therefore, it should be part of the follow-ups. Key points • In our study, cardiac functions and pericardial thickening of 99 FMF patients with and without attack were prospectively investigated. • In ongoing follow-up of patients with FMF, we found that inflammation, which affects all serosas, also affects the pericardium during the attract and nonattack phase. • We believe that cardiac functions, including the status of the pericardium, should be monitored as part of the long-term follow-up of FMF

Evaluation of non-infectious complications of peritoneal dialysis in children: a multicenter study

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