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    Approaches of Pediatric Nephrologists to Hypertensive Patients in Turkey (Turkish Pediatric Hypertension Working Group Study)
    (Aves, 2022) Kasap-Demir, Belde; Tasdemir, Mehmet; Ovunc-Hacihamdioglu, Duygu; Girisgen, Ilknur; Dursun, Hasan; Civilibal, Mahmut; Benzer, Meryem
    Objective: We aimed to evaluate the approaches of pediatric nephrologists in our country to the management of childhood hypertension. Methods: The pediatric nephrologists in our country were invited to fill out an online questionnaire including 24 questions. The answers were compared between those working in the field for <= 10 years (Group 1, n =74) and >10 years (Group 2, n = 62). Results: Of 136 participants (M/F = 101/35), 52% were following a single guideline [31% Fourth Report of 2004, 17% European Society of Hypertension in 2016, and 52% American Academy of Pediatrics in 2017], which is more common in Group 1 (P =.035). The most commonly used guideline was American Academy of Pediatrics of 2017 and Group 2 used Fourth Report of 2004 more commonly (P =.042). The most common choice to diagnose hypertension was office + home + ambulatory blood pressure monitoring (59%). The frequency of screening for end-organ damage at first evaluation was 96%. The time to wait for the effect of lifestyle modifications was 3 months in 52%. The first choice medication was angiotensin-converting enzyme inhibitors (49%) or calcium-channel blockers (48%) in non-obese and angiotensin-converting enzyme inhibitors (74%) in obese children. Calcium-channel blockers were more commonly prescribed as the first choice in non-obese children in Group 1 (P =.035). The most accessible emergency drug was esmolol. Conclusion: Despite following recent guidelines, the time spent in the proficiency would change the practices.
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    APPROACHES OF PEDIATRIC NEPHROLOGISTS TO HYPERTENSIVE PATIENTS IN TURKEY (TURKISH PEDIATRIC HYPERTENSION WORKING GROUP STUDY)
    (Springer, 2018) Demir, Belde Kasap; Tasdemir, Mehmet; Hacihamdioglu, Duygu Ovunc; Girisgen, Ilknur; Dursun, Hasan; Civilibal, Mahmut; Benzer, Meryem
    [Abstract Not Available]
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    RITUXIMAB TREATMENT FOR DIFFICULT-TO-TREAT NEPHROTIC SYNDROME IN CHILDREN: A MULTICENTER STUDY
    (Springer, 2018) TaSdemir, Mehmet; Canpolat, Nur; Yildiz, Nurdan; Ozcelik, Gul; Benzer, Meryem; Saygili, Seha Kamil; Ozkayin, Nese
    [Abstract Not Available]
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    Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study
    (Tubitak Scientific & Technological Research Council Turkey, 2021) TasdemIr, Mehmet; Canpolat, Nur; Yildiz, Nurdan; OzcelIk, Gul; Benzer, Meryem; Saygili, Seha Kamil; Ozkayin, Emine Nese
    Background/aim: This study aimed to evaluate the efficacy of rituximab in children with difficult-to-treat nephrotic syndrome, considering the type of disease (steroid-sensitive or -resistant) and the dosing regimen. Materials and methods: This multicenter retrospective study enrolled children with difficult-to-treat nephrotic syndrome on rituximab treatment from 13 centers. The patients were classified based on low (single dose of 375 mg/m(2)) or high (2-4 doses of 375 mg/m(2)) initial dose of rituximab and the steroid response. Clinical outcomes were compared. Results: Data from 42 children [20 steroid-sensitive (frequent relapsing / steroid-dependent) and 22 steroid-resistant nephrotic syndrome, aged 1.9-17.3 years] were analyzed. Eleven patients with steroid-sensitive nephrotic syndrome (55%) had a relapse following initial rituximab therapy, with the mean time to first relapse of 8.4 +/- 5.2 months. Complete remission was achieved in 41% and 36% of steroid-resistant patients, with the median remission time of 3.65 months. At Year 2, eight patients in steroid-sensitive group (40%) and four in steroid-resistant group (18%) were drug-free. Total cumulative doses of rituximab were higher in steroid-resistant group (p = 001). Relapse rates and time to first relapse in steroid-sensitive group or remission rates in steroid-resistant group did not differ between the low and high initial dose groups. Conclusion: The current study reveals that rituximab therapy may provide a lower relapse rate and prolonged relapse-free survival in the steroid-sensitive group, increased remission rates in the steroid-resistant group, and a significant number of drug-free patients in both groups. The optimal regimen for initial treatment and maintenance needs to be determined.