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Öğe Childhood vasculitides in Turkey: A nationwide survey(2007) Ozen S.; Bakkaloglu A.; Dusunsel R.; Soylemezoglu O.; Ozaltin F.; Poyrazoglu H.; Kasapcopur O.; Ozkaya O.; Yalcinkaya F.; Balat A.; Kural N.; Donmez O.; Alpay H.; Anarat A.; Mir S.; Gur-Guven A.; Sonmez F.; Gok F.Aim: The aims of this study were to evaluate the characteristics of childhood vasculitides and to establish the first registry in Turkey, an eastern Mediterranean country with a white population. Patients and methods: A questionnaire was distributed to the main referral centers asking for the registration of the Henoch-Schönlein purpura (HSP) patients in the last calendar year only and 5 years for other vasculitides. Demographic, clinical, and laboratory data were assessed. Results: Vasculitic diseases were registered from 15 pediatric centers. These centers had a fair representation throughout the country. In the last calendar year, incidences were as follows: HSP 81.6%, Kawasaki disease (KD) 9.0%, childhood polyarteritis nodosa (C-PAN) 5.6%, Takayasu arteritis (TA) 1.5%, Wegener's granulomatosis 0.4%, and Behçet disease 1.9%. There was no clear gender dominance. The mean age was 11.05±4.89 years. Acute phase reactants were elevated in almost all, highest figures being in C-PAN. Renal involvement was present in 28.6% of HSP and 53% of the C-PAN patients. Abdominal aorta was involved in all TA patients. Among the C-PAN patients, 25% had microscopic PAN with necrotizing glomerulonephritis; antineutrophil cytoplasmic antibody was positive in those who were studied. Among the patients, 12.5% and 15% had classic PAN and cutaneous PAN, respectively. The remaining majority were classified as systemic C-PAN diagnosed with biopsies and/or angiograms demonstrating small to midsize artery involvement. The overall prognosis was better than reported in adult series. Conclusion: This is the largest multicenter study defining the demographic data for childhood vasculitides. The distribution of childhood vasculitides was different in our population where KD is much less frequent, whereas HSP constitutes an overwhelming majority. C-PAN was more frequent as well. © Clinical Rheumatology 2006.Öğe Indoxyl sulfate associates with cardiovascular phenotype in children with chronic kidney disease(Springer Verlag, 2019) Holle J.; Querfeld U.; Kirchner M.; Anninos A.; Okun J.; Thurn-Valsassina D.; Bayazit A.; Niemirska A.; Canpolat N.; Bulut I.K.; Duzova A.; Anarat A.; Shroff R.; Bilginer Y.; Caliskan S.; Candan C.; Harambat J.; Özcakar Z.B.; Soylemezoglu O.; Tschumi S.; Habbig S.; Yilmaz E.; Balat A.; Zurowska A.; Cakar N.; Kranz B.; Ertan P.; Melk A.; Azukaitis K.; Schaefer F.Background: Cardiovascular disease is the leading cause of death in children with chronic kidney disease (CKD). Serum levels of gut-derived uremic toxins increase with deterioration of kidney function and are associated with cardiac comorbidities in adult CKD patients. Methods: Indoxyl sulfate (IS) and p-cresyl sulfate (pCS) were measured by high-performance liquid chromatography in serum of children participating in the Cardiovascular Comorbidity in Children with CKD (4C) Study. Results were correlated with measurements of the carotid intima-media thickness (cIMT), central pulse wave velocity (PWV), and left ventricular mass index (LVMI) in children aged 6–17 years with initial eGFR of 10–60 ml/min per 1.73 m2. Results: The median serum levels of total IS and of pCS, measured in 609 patients, were 5.3 µmol/l (8.7) and 17.0 µmol/l (21.6), respectively. In a multivariable regression model, IS and pCS showed significant positive associations with urea and negative associations with eGFR and uric acid. Furthermore, positive associations of pCS with age, serum albumin, and non-Mediterranean residency and a negative association with glomerular disease were observed. By multivariable regression analysis, only IS was significantly associated with a higher cIMT SDS at baseline and progression of PWV SDS within 12 months, independent of other risk factors. Conclusions: Serum levels of gut-derived uremic toxins IS and pCS correlated inversely with eGFR in children. Only IS was significantly associated with surrogate markers of cardiovascular disease in this large pediatric CKD cohort. © 2019, IPNA.Öğe Predictive value of the “Blood Pressure To Height Ratio” in diagnosis of prehypertension and hypertension during childhood in Southeastern Turkey(Taylor and Francis Ltd, 2019) Çöl N.; Kilinc A.; Demircioğlu-Kılıç B.; Aydin N.; Keskin M.; Balat A.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. © 2018, © 2018 Taylor & Francis.
