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Öğe Acute kidney injury in an adolescent: Answers(Springer, 2021) Nalcacıoğlu, Hülya; Tekcan, Demet; Can Meydan, Bilge; Özkaya, OzanFirst, we excluded the chronic state of this patient by looking at his previous creatinine value and experienced an acute rise in the plasma creatinine so defined as acute kidney injury (AKI)Öğe Acute kidney injury in an adolescent: Questions(Springer, 2021) Nalcacıoğlu, Hülya; Tekcan, Demet; Can Meydan, Bilge; Özkaya, OzanA 17-year-old male was admitted to a local hospital with complaints of vomiting, abdominal pain, and loose watery non bloody stools per 3 days. At the same time, he noticed a decrease in his urine output over the last 2 days. His past medical history was unremarkable. There was no history of ingesting undercooked meat, fever, ill contact, or taking any medication. He was the son of healthy non-consanguineous parents. On admission, hypotension and tachycardia was noted and physical examination was unremarkable. He had received intravenous fluid replacement for 2 days at this local hospital. Due to decrease in urine output and deterioration of his renal function (serum creatinine 4.6 mg/dl) with acidosis (pH 7.2, HCO3 10 mEq/l), the patient was transferred to our centerÖğe Complement gene mutations in children with C3 glomerulopathy: do they affect the response to mycophenolate mofetil?(Springer, 2024) Gunay, Neslihan; Dursun, Ismail; Gokce, Ibrahim; Kara, Mehtap Akbalik; Tekcan, Demet; Cicek, Neslihan; Bayram, Meral TorunBackgroundC3 glomerulopathy (C3G) is a complement-mediated disease. Although genetic studies are not required for diagnosis, they are valuable for treatment planning and prognosis prediction. The aim of this study is to investigate the clinical phenotypes, kidney survival, and response to mycophenolate mofetil (MMF) treatment in pediatric C3G patients with and without mutations in complement-related genes.MethodsSixty pediatric C3G patients were included, divided into two groups based on complement-related gene mutations. Demographic and clinical-pathological findings, treatment modalities, and outcome data were compared, and Kaplan-Meier analysis was performed for kidney survival.ResultsOut of the 60 patients, 17 had mutations. The most common mutation was in the CFH gene (47%). The mean age at diagnosis was higher in the group with mutation (12.9 +/- 3.6 vs. 11.2 +/- 4.1 years, p = 0.039). While the patients without mutation most frequently presented with nephritic syndrome (44.2%), the mutation group was most likely to have asymptomatic urinary abnormalities (47.1%, p = 0.043). Serum parameters and histopathological characteristics were similar, but hypoalbuminemia was more common in patients without mutation. During 45-month follow-up,10 patients progressed to chronic kidney disease stage 5 (CKD5), with 4 having genetic mutation. The time to develop CKD5 was longer in the mutation group but not significant. MMF treatment had no effect on progression in either group.ConclusionsThis study is the largest pediatric C3G study examining the relationship between genotype and phenotype. We showed that the mutation group often presented with asymptomatic urinary abnormalities, was diagnosed relatively late but was not different from the without mutation group in terms of MMF treatment response and kidney survival.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary informationÖğe The evaluation of left ventricular functions in children with steroid-sensitive nephrotic syndrome(Springer, 2018) Nalcacıoğlu, Hülya; Özkaya, Ozan; Kafalı, Candaş; Tekcan, Demet; Baysal, Kemal: Nephrotic syndrome has been associated with increased risk of cardiovascular diseases (CVD), which may be attributable to the hypoalbuminemia, dyslipidemia, hypercoagulopathy or inflammatory activation. In childhood minimal change disease is less prone to CVD because of the transient nature of the metabolic abnormalities and steroid exposure. The aim of the present study was to evaluate the presence of cardiac systolic and diastolic dysfunction in pediatric patients with steroid – sensitive nephrotic syndrome (SSNS).Öğe Nutcracker syndrome in children: role of doppler ultrasonographic indices in detecting the pattern of symptoms(Mdpi, 2018) Nalçacıoğlu, Hülya; Bilgici, Meltem Ceyhan; Tekcan, Demet; Genç, Gürkan; Bostancı, Yakup; Yakupoğlu, Yarkın Kamil; Özkaya, OzanThe purpose of this study was to evaluate the clinical characteristics of 44 pediatric patients who were diagnosed as having nutcracker syndrome (NCS). We also investigated the left renal vein Doppler ultrasonography (DUS) results, to determine whether or not there was an association between clinical symptoms and DUS findings among these patients. The clinical data from 44 pediatric patients who were diagnosed as having NCS from January 2008 to December 2015 were retrospectively reviewed. We grouped the patients according to the presenting symptoms as symptomatic (loin pain; macroscopic hematuria or both) and non-symptomatic (microscopic hematuria and proteinuria were detected incidentally) and evaluated the left renal vein DUS indices in these two groups separately. Asymptomatic NCS was found in 27 (61.4%) patients; 21 (47.7%) of whom were admitted for the evaluation of proteinuria. The most frequent presenting symptoms were left flank pain (20.5%) and macroscopic hematuria (13.6%); and 2 (4.5%) patients presented with a combination of left flank pain and macroscopic hematuria. The mean ratio of the diameter of the hilar portion of the left renal vein (LRV) to that of the aortomesenteric portion was 4.36 +/- 1.55. The mean ratio of the peak velocity (PV) between the two sites of the LRV was 7.32 +/- 2.68 (3.1-15.6). The differences in the ratio of the diameters were statistically significant between the two groups and significantly higher in children with asymptomatic NCS (p = 0.025). The PV ratios of the LRV (p = 0.035) were significantly higher in asymptomatic children with NCS than in the symptomatic group. Our study identifies that increased compression ratio of the LRV entrapment is most observed in orthostatic proteinuria and microscopic hematuria.Öğe The results of rituximab therapy in the patients with steroid dependent nephrotic syndrome(Springer, 2018) Tekcan, Demet; Aydoğ, Özlem; Gene, Gürkan; Kendirci, Nergis; Nalçacıoğlu, Hülya; Özkaya, Ozan: The patients with steroid dependent nephritic syndrome (SDNS) require prolonged steroid therapy. To reduce the side effects of prolonged steroid therapy, alternative treatments which have steroidsparing effect are required. Alternative treatments include alkylating agents such as cyclophosphamide or chlorambucil, mycophenolate mofetil (MMF), cyclosporine, and more recently rituximab (RTX).Öğe A single center study of the patients with cystinuria(Springer, 2018) Tekcan, Demet; Aydoğ, Özlem; Genç, Gürkan; Kendirci, Nergis; Nalçacıoğlu, Hülya; Özkaya, Ozanbe partially treated with bicarbonate, bone marrow transplantation or possibly gene therapy.
