We investigated the value of genetic, histopathologic, and early treatment response information in prognosing long-term renal outcome in children with primary steroid-resistant nephrotic syndrome. ...From the PodoNet Registry, we obtained longitudinal clinical information for 1354 patients (disease onset at >3 months and <20 years of age): 612 had documented responsiveness to intensified immunosuppression (IIS), 1155 had kidney biopsy results, and 212 had an established genetic diagnosis. We assessed risk factors for ESRD using multivariate Cox regression models. Complete and partial remission of proteinuria within 12 months of disease onset occurred in 24.5% and 16.5% of children, respectively, with the highest remission rates achieved with calcineurin inhibitor-based protocols. Ten-year ESRD-free survival rates were 43%, 94%, and 72% in children with IIS resistance, complete remission, and partial remission, respectively; 27% in children with a genetic diagnosis; and 79% and 52% in children with histopathologic findings of minimal change glomerulopathy and FSGS, respectively. Five-year ESRD-free survival rate was 21% for diffuse mesangial sclerosis. IIS responsiveness, presence of a genetic diagnosis, and FSGS or diffuse mesangial sclerosis on initial biopsy as well as age, serum albumin concentration, and CKD stage at onset affected ESRD risk. Our findings suggest that responsiveness to initial IIS and detection of a hereditary podocytopathy are prognostic indicators of favorable and poor long-term outcome, respectively, in children with steroid-resistant nephrotic syndrome. Children with multidrug-resistant sporadic disease show better renal survival than those with genetic disease. Furthermore, histopathologic findings may retain prognostic relevance when a genetic diagnosis is established.
Dear Colleagues, I would like to share this editorial not as the current Editor-in-Chief of the European Journal of Therapeutics (Eur J Ther), formerly Gaziantep Medical Journal (Gaziantep Med J), ...but as the former Editor-in-Chief between 2007 and 2010. It is a great pleasure and pride to celebrate the thirty-fifth anniversary of the Eur J Ther. In 2007, when I was appointed as the Dean of Gaziantep University Faculty of Medicine, unfortunately, the journal, the last issue of which was published in 2001, was in a five-year pause. In 1990, despite limited means, the journal had started its publication life 1, and it was a significant shortcoming not to be published. This scientific spark, launched in 1990, should not have been extinguished. Among the several projects we carried out during my tenure as a Dean, the one that made me the happiest was the resumption of the journal's publication. A dedicated team worked wholeheartedly for this journal despite many impossibilities. And, at the end of a serious process of five years, the journal was reborn from its ashes like a phoenix in 2007! At that time, many index applications of our journal, especially the ULAKBIM TR Index, were approved. Similarly, we increased the number of issues in a year from two to three during this period 2. In 2010, I handed over the journal's editor-in-chief with great pleasure. Perhaps what made me the happiest in my academic career was my period as Editor-in-Chief between 2007 and 2010 and the journal's progress. It is also a source of happiness and pride that I am now contributing again as Editor-in-Chief in the thirty-fifth year of the journal. I would like to express my gratitude to all authors, editors, referees and technical staff who have contributed to the journal in this thirty-five-year period. With the hope that there will be many more beautiful years to celebrate, Yours sincerely,
Hypertension (HT) is one of the major problems in chronic kidney disease (CKD), not only for adults, but also for children. It is one of the main factors in the progression of CKD, increased rate of ...cardiovascular disease, and impairment in quality of life. The most important devastating effect of HT is on the cardiovascular system. It may leave significant footprints in developing children that can be carried over to adulthood. Existing data clearly show that in CKD children with proteinuria the blood pressure goal should be 50th centile, while it is 75th centile in those without proteinuria. Renin-angiotensin system inhibitors are considered the first choice pharmacological option in hypertensive CKD stage 2 to 4 patients. However, in clinical practice, pediatric nephrologists may experience significant problems in treatment and follow-up of these patients, especially in compliance. Due to multiple drug use, physician-patient and family cooperation would be essential to improve the compliance. Remembering the fact that prevention is always cheaper than treatment, we need early detection of CKD and its devastating complications, like HT. Therefore, active screening programs should be encouraged in children, as well as trying to find new biomarkers, inspired from the footprints of HT. Although the researches on new urinary biomarkers for early detection of CKD and HT are promising, more studies are needed in this area. This review aims to give an overview of HT in CKD children, mainly focusing on importance of HT, basic principles of treatment, problems in follow up, and possible markers for early detection of CKD and HT.
Background
Acute post‐streptococcal glomerulonephritis (APSGN) is the most common post‐infectious glomerulonephritis in childhood. The aim of this study was therefore to identify the possible risk ...factor(s) responsible for decreased glomerular filtration rate (GFR) in APSGN.
Methods
The data of patients followed up with a diagnosis of APSGN in the Pediatric Nephrology Clinic of Gaziantep University Hospital between October 2014 and October 2016 were retrospectively evaluated.
Results
The total number of subjects was 75 (male/female, 42/33) with a mean age of 8.20 ± 3.25 years. The most common presentations were edema (86.7%), macroscopic hematuria (82.7%) and hypertension (73.3%, n = 55). On laboratory examination, 28 children (37.3%) had hypoalbuminemia, 58 (77.3%) had proteinuria, 20 (26.7%) had increased C‐reactive protein (CRP), while 74 (98.7%) and 12 (16%) had decreased complement (C)3 and C4, respectively. The number of children with GFR <90 mL/min/1.73 m2 was 22 (29.3%). The risk of decreased GFR was significantly higher in patients with increased CRP (P = 0.001; OR, 3.58), hypoalbuminemia (P = 0.006; OR, 4.83), and decreased C4 (P = 0.010; OR, 11.53). Additionally, white blood cell (WBC) count, neutrophil count, and neutrophil/lymphocyte ratio (NLR) were significantly higher (P = 0.02, P = 0.006, P = 0.004, respectively) in patients with low GFR.
Conclusions
Although the prognosis of APSGN in children is good, severe systemic complications and renal failure may develop during the follow‐up period. Decreased C4, presence of hypoalbuminemia, and increased inflammatory markers (WBC, CRP, neutrophil count and NLR) might be possible risk factors for severity of renal involvement. Decreased C4, in particular, may be a risk factor for decreased GFR in those children.
Hyponatremic-hypertensive syndrome (HHS) is an uncommon disorder rarely seen in children. Herein, we report a 19-month-old boy with HHS. He had severe hypertension, polyuria, polydipsia, vomiting, ...and seizure at presentation. Laboratory findings revealed hyponatremia, hypokalemia, metabolic alkalosis, proteinuria, hypercalciuria, high levels of renin and aldosterone, and renal artery stenosis. All symptoms resolved after nephrectomy. Clinicians should be aware of this syndrome because prompt recognition can be lifesaving.
The extent and relevance of altered bone metabolism for statural growth in children with chronic kidney disease is controversial. We analyzed the impact of renal dysfunction and recombinant growth ...hormone therapy on a panel of serum markers of bone metabolism in a large pediatric chronic kidney disease cohort.
Bone alkaline phosphatase (BAP), tartrate-resistant acid phosphatase 5b (TRAP5b), sclerostin and C-terminal FGF-23 (cFGF23) normalized for age and sex were analyzed in 556 children aged 6-18 years with an estimated glomerular filtration rate (eGFR) of 10-60 ml/min/1.73 m2. 41 children receiving recombinant growth hormone therapy were compared to an untreated matched control group.
Standardized levels of BAP, TRAP5b and cFGF-23 were increased whereas sclerostin was reduced. BAP was correlated positively and cFGF-23 inversely with eGFR. Intact serum parathormone was an independent positive predictor of BAP and TRAP5b and negatively associated with sclerostin. BAP and TRAP5B were negatively affected by increased C-reactive protein levels. In children receiving recombinant growth hormone, BAP was higher and TRAP5b lower than in untreated controls. Sclerostin levels were in the normal range and higher than in untreated controls. Serum sclerostin and cFGF-23 independently predicted height standard deviation score, and BAP and TRAP5b the prospective change in height standard deviation score.
Markers of bone metabolism indicate a high-bone turnover state in children with chronic kidney disease. Growth hormone induces an osteoanabolic pattern and normalizes osteocyte activity. The osteocyte markers cFGF23 and sclerostin are associated with standardized height, and the markers of bone turnover predict height velocity.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Hamse-i Şanizade (Khamse Shānī-zāde) is the most important work of Şanizade Mehmed Ataullah Efendi (1769 or 1771-1826), an Ottoman kadı (qāḍi), physician, historian, polymath, and polyglot, about ...medicine and consists of 5 books. The first book, Mir'āt al-ebdān fī teshrīḥ a'dā' al-insān, is on anatomy. The second book, Uṣūl al-ṭabī'a, deals with physiology, while the third, Mi'yār al-etıbbā, mentions diseases and their treatments. These books were published together in Istanbul in 1820. A fourth book, Qānūn al-cerrāḥīn, published in Cairo after his death in 1828, discusses surgical treatments of diseases. A fifth book, Mīzān al-edviye, is a pharmacopeia. In this study, we examined the information about urinary system anatomy, physiology, diseases, and their medical and surgical treatments in Hamse-i Şanizade.
We examined the first 3 books and the fourth book. The relevant passages were translated into English after being transliterated into the contemporary Turkish alphabet.
In the first book, kidney anatomy is discussed under the heading "fī teshrīḥ al-kulā" and bladder anatomy under "fī teshrīḥ al-methāne." In the second book, the formation and excretion of urine are explained in different headings. In the third book, kidney inflammation and its treatment are discussed, with kidney and bladder stones and their medical treatments explained in detail. Finally, the types and treatments of urinary retention are discussed, with types, causes, symptoms, prognosis, and surgical treatments of bladder stones written in detail.
In the Ottoman Empire, Hamse-i Şanizade is regarded as one of the first gateways to the West in the field of medicine. It was instrumental in modernizing Ottoman-Turkish medicine and contains and reflects the state-of-the-art knowledge of the time regarding the anatomy, physiology, diseases, and medical and surgical treatments of the urinary system.
Dear Colleagues,
Recently, for an article submitted to the European Journal of Therapeutics, it was reported that the paper may have been written with artificial intelligence support at a rate of ...more than 50% in the preliminary examination made with Turnitin. However, the authors did not mention this in the article’s material method or explanations section. Fortunately, the article’s out-of-date content and fundamental errors in its methodology allowed us no difficulty making the desk rejection decision.
On the other hand, similar situations that we may encounter later caused us to discuss how we would decide when the artificial intelligence support of the articles was written. The general opinion that we have adopted and currently available in the literature is that if artificial intelligence is used while writing an article, how artificial intelligence is used in the methodology should be written in detail.
Moreover, we encountered a much more exciting situation during our evaluation. In a few academic studies, we have seen that artificial intelligence is added as a co-author. On July 06, 2023, in the Web of Science, using the advanced search, we found four articles with the author name ChatGPT 1. We have determined that ChatGPT is the author in one of these articles 2 and the Group Author in three 3-5.
Lee 6 stated that although artificial intelligence tools are much more advanced than search engines, they cannot be an author regarding research ethics because they cannot take responsibility for what they write. Similarly, Goto and Katanoda 7 stated that it is the author’s responsibility to confirm that the texts written by ChatGPT are correct. However, Pourhoseingholi et al. 8 reported that keeping up with technology is inevitable. Additionally, they said that“this action will be more fruitful and practical in extended dimensions when international institutes like ICMJE or COPE come up with the appropriate adjustments and establish robust criteria to scheme the AI authorship”.
Most probably, the use of artificial intelligence applications in scientific articles and whether it can be a co-author in these papers will be discussed soon.
We encourage interested authors to submit their ideas to our journal as a letter to the editor.
Yours sincerely,
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.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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