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

Conservative management of non-refluxing non-obstructive megaureter: A longitudinal observational study

Introduction: There is a lack of prospective studies that include a selected population of patients with non-refluxing non-obstructive megaureter (MU). We aimed to examine the 2-year follow-up results of non-refluxive non-obstructive MU patients who dont require surgery.. Material and methods: 17[(22 kidney units (KU))MU cases who were followed up between 2018 and 2021 at Medipol University, Faculty of Medicine, Division of Pediatric Nephrology were included in the study. Group 1 was defined as improved or regressed KU according to hydronephrosis degrees and diameters. Group 2 was defined as worsened or remained stable KU. Cases were analyzed retrospectively ultrasonographic (US) findings, in terms of urinary tract infection (UTI) frequency, stone and growth (height and weight SDS scores) parameters. Results: 13 (76.4%) of the 17 cases were diagnosed antenatally. 13 of cases were boys. 3 of the 17 cases were found on the right side, 5 were bilateral and 9 were found on the left side. We determined no statistically significant difference in terms of hydronephrosis severity, UTI frequency or initial and final growth scores between Group 1 and Group 2 (Table 1). Conclusions: Although US findings cause concern for the doctor and parents in MU cases without reflux and obstruction, we could be interpreted to these cases having a low risk of causing problems in terms of UTI, parenchymal damage and growth

Is it possible to perform less vcug?

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Urinary stones in children: A single center experience

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Examination of patients with acute kidney injury in the pediatric intensive care unit

Introduction: Acute kidney injury (AKI), has negatively impacting the mortality and morbidity of patients in pediaric intensive care units. We aimed to investigate AKI causes, risk factors and factors affecting survival in children while being monitored in the pediatric intensive care unit (PICU). Material and methods: 328 patients, who were followed up in the PICU between January 2018 and March 2021 for various reasons, were examined retrospectively. 43 (13,1%) patients who diagnosed with AKI without prior chronic kidney injury were included in the study. Results of demographic data, primary diagnosis, AKI causes, risk factors and Pediatric Risk of Mortality (PRISM III) scores of surviving and deceased were compared. Results: 15 of AKI patients (34,9%) were girls. The mean age was 6.18 ± 5.61 (median: 5) years. On the first day of hospitalization in PICU, PRISM III scores were 19.48 ± 9.65 (median: 19). Acute lymphoblastic leukemia was the most common primary disease with 7 patients (16,2%). Median PICU length of stay was 10 days. We found that 30 (89,7%) patients developed AKI while being followed up with a mechanical ventilator and 28 (65,1%) of these patients used nephrotoxic drugs before AKI developed. It was found that 17 (39,5%) cases developed oliguria and/or anuria, and 36 (83,7%) patients developed multiple organ failure. Dialysis treatment was applied to 8 (18,6%) patients and continuous dialysis treatment methods were preferred in all of them. Median duration of dialysis time was 3,5 days. 28 (65,1%) patients died. PRISM scores, sepsis and dialysis requirement were found to be statistically significantly higher in deceased than surviving patients (respectively p= 0.001, p=0.001, p=0.001). Conclusions: Despite technological advances, AKI is an important cause of mortality and morbidity in critically ill patients. PRISM scoring and the presence of sepsis can be considered as an important determinant in predicting mortality and acting early for the dialysis decision