Ipek Kaplan Bulut

Zeynep Kamil Women's and Children's Disease Training and Research Hospital, İstanbul, Istanbul, Turkey

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Publications (13)6.31 Total impact

  • I Kaplan Bulut · O D Kara · K Ozdemir · N Dincel · E Yılmaz · M O Bulut · B Sozeri · H Bicer · S Mir
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    ABSTRACT: The purposes of study were to emphasize the importance of RIFLE in early diagnose and prognosis of Acute Kidney Injury and to evaluate the practicability of the RIFLE criteria in intensive care units. Sixty-six patients applied acute peritoneal dialysis were included into the study. Patients having acute peritoneal dialysis within the first 24 hours of intensive care unit admission were named group 1, between 24-48 hours group 2 and those who had acute peritoneal dialysis 48 hours or more after admission to the intensive care unit were named group 3. Retrospectively, we evaluated patients by RIFLE criteria at the consultation time and patients had been just in acute kidney injury were called late referral patients. The mean interval time between the onset of acute kidney injury and the consultation time was defined as delay time in late referral patients. There were 20 patients in group 1, 15 were in group 2 and 31 in group 3. In total there were 18/66 patients in Risk, 13/66 in Injury while 35/66 in Failure. There was statistically difference between delay times of in Risk and Failure class in group 3 (p < 0.05). Also delayed patient numbers of both Risk and Failure class were found statistically highly significant (p < 0.001). Most of the patients were in failure class at the time of consultation. We guess that if they would have been diagnosed earlier, prognosis might have been better. Therefore early diagnosis of acute kidney injury with RIFLE criteria and early initiation of acute peritoneal dialysis would probably improve prognosis.
  • S Mir · B Sozeri · M Deveci · K Ozdemir · Z H Gun · N Dincel · G Gozuoglu · E Yılmaz · I Kaplan Bulut
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    ABSTRACT: Primary hypertension in children is not a benign condition because of end--organ damage. Early investigations of cardiovascular effects rely on vascular structural and functional changes. We aimed to determine presence of early cardiovascular involvement in children with primary hypertension. For this purposes, we investigated functional and morphological changes in vascular system. Seventy--five consecutive patients with primary hypertension and 35 healthy children comparable for age and gender were studied. Patients were classified according to the stages of blood pressure. Intima--media thickness of the carotid arteries (cIMT), carotid--femoral pulse wave velocity (PWVcf) and pulse wave augmentation index (AIx) and left ventricular mass index (LVMi) were investigated. PWVcf and AIx were higher in patients (5.87 ± 0.87 m/s vs 5.29± 0.67 m/s, P =0.02; 9.41± 8.54% vs8.36 ± 3.59%, P =0.04, respectively) than in controls. cIMT was evaluated significantly higher in study group than controls(0.46 ±0.06 mm vs 0.35± 0.12 mm, respectively, P =0,01). The mean LVMi was higher in patients (32.9 ± 11.5 vs 28.8± 1.55, p=0.01). Our results demonstrated that, vascular findings were more sensitive for target organ changes than the more frequently utilized LVMi in patients with pre--hypertension.
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    ABSTRACT: Introduction: As intensive care units (ICU) have improved, presence of multiple-organ dysfunctions in majority of patients with acute renal failure (ARF) has become clearer. To facilitate multi-organ support, continuous renal replacement therapy (CRRT) techniques have been developed. This study is the one that reports the experience on children including newborns receiving CRRT monitored in ICU. Materials and Methods: The study was performed retrospectively in children who had Continuous Veno- Venous Hemodiafiltration (CVVHDF) as a CRRT modality in ICU. Clinical data, primary cause, consultation time, duration and initiation time of CVVHDF were recorded. Patients were classified as cardiac and non-cardiac in respect to primary dysfunction. Stage of renal failure was evaluated according to pRIFLE criteria. Outcome was identified as primary and secondary. Primary outcome was accepted as the composite correction of uremia and metabolic parameters, and regression of fluid overload, while secondary outcomes were assessed as improvement of hemodynamic instability and survival. Results: A total of 36 patients’ files were scanned. There were 10 cases in cardiac group and 26 cases in non-cardiac group. There were statistically better differences between primary and secondary outcome rates of cardiac cases. Although there was no difference between cardiac and non-cardiac cases in terms of primary outcome, secondary outcome was statistically significant. Timing of consultation and CVVHDF was not found to have an effect on the outcome. Conclusion: Our results indicated that CVVHDF treatment was successful even in cardiac patients with high mortality and in patients at their later stage of ARF.
    Renal Failure 09/2014; 36(9). DOI:10.3109/0886022X.2014.950932 · 0.78 Impact Factor
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    ABSTRACT: Adrenarche is a component of normal pubertal development. Recent decades have witnessed changes in the timing and tempo of puberty in different populations. We aimed to obtain normative data on dehydroepiandrosterone-sulphate (DHEA-S) secretion in healthy children and to evaluate the age of adrenarche, pubarche and the DHEA-S levels at which pubarche starts in both sexes. Serum DHEA-S concentrations were measured in 531 healthy (291 female) Turkish children aged 1 month–18 years by an automated chemiluminescence method. Pubic hair development was evaluated. DHEA-S concentrations >108·4 nmol/l (40 μg/dl) were regarded as adrenarche. Age-related normative data were constructed. Age at adrenarche and pubarche and the DHEA-S levels at pubarche were estimated using ROC analyses. Serum DHEA-S levels were high in the first 6 months of life then declined below 108·4 nmol/l (40 μg/dl) with a cut-off age of 0·46 years for girls and 0·61 years for boys with 98% and 96% statistical sensitivity. Stable minimum levels were observed for the following 5 years. The cut-off age for DHEA-S levels rising above 108·4 nmol/l (40 μg/dl) was 8·0 and 7·0 years for girls for boys, respectively. DHEA-S levels at transition from Tanner stage P1 to P2 was 90·5 nmol/l (33·4 μg/dl) in girls and 118 nmol/l (43·6 μg/dl) in boys. Median (CI) DHEA-S levels were 170·7(94·8–336) and 244(119·2–357·7) nmo/l [63(35–124) and 90(44–132) μg/dl] in girls and boys, respectively, with Tanner stage P2 pubic hair. We established reference data of serum DHEA-S levels in a large group of children. Currently, adrenarche (DHEA-S>108·4 nmol/l) starts 1 year earlier in boys but higher DHEA-S levels are needed for transition from P1 to P2 in boys.
    Clinical Endocrinology 09/2014; 82(5). DOI:10.1111/cen.12612 · 3.35 Impact Factor
  • 03/2014; 8(1):12-16. DOI:10.12956/tjpd.2014.38
  • Ipek Kaplan Bulut · Sevgi Mir · Afig Berdeli · Betul Sozeri
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    ABSTRACT: Background: Vesicoureteral reflux (VUR) is a risk factor for progressive kidney damage especially when it is accompanied by urinary tract infections (UTIs). Uroplakins (UPs) are integral proteins found in the structure of urothelium. In the present study, we evaluated the usefulness of urinary UPIb messenger ribonucleic acid (mRNA) levels as an early and noninvasive diagnostic tool for VUR and as an indicator for predisposition to UTI. Methods: Urinary UPIb mRNA levels were determined in patients experiencing their first UTI episode (n = 28) or recurrent UTI (n = 31) as well as patients having UTI with VUR (n = 30). These results were compared to a control group (n = 26). Results: The UPIb mRNA values among patients diagnosed with their first UTI were lower, but not statistically different, than those in the control group. The UPIb mRNA levels of patients with recurrent UTI and UTI with VUR were significantly lower than those observed in control individuals. Conclusion: Urine UPIb levels may be useful for predicting the risk of recurrent UTI in patients diagnosed with their first UTI and may also be considered as a noninvasive screening test for VUR.
    Clinical nephrology 03/2014; 81(3):152-8. DOI:10.5414/CN107778 · 1.23 Impact Factor
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    Dataset: IgA
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    N Dincel · I K Bulut · T Ö Sezer · S Mir · C Hoşcoşkun
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    ABSTRACT: Everolimus is a potent immunosuppressive agent that has antiproliferative activities. This study sought to share our experience among renal transplanted children who required conversion from calcineurin inhibitors (CNIs) to the mammalian target of rapamycin inhibitor everolimus. Exclusion criteria were multiple organ transplantations, loss of a previous graft due to immunologic reasons, receipt of an organ donated after cardiac death, donor age <5 years or >65 years, panel reactive antibodies >25%, platelets <75,000/mm(3), absolute neutrophil count of <1,500/mm(3), leucocytes <2,500/mm(3), hemoglobin <6 g/dL, severe liver disease, cold ischemia time >40 hours or anti-HLA panel-reactive antibodies >50%. Eighteen renal transplant patients (10 male, 8 female) underwent conversion to everolimus from CNI: 8 from cyclosporine (CsA) and 10 from tacrolimus. The mean age was 12.6 ± 0.9 years and the mean body mass index 21.8 ± 1.7 kg/m(2). The mean 2-hour postdose level of CsA before conversion was 671 ± 142 ng/mL; the patients on tacrolimus showed a mean trough concentration of 4.5 ng/mL. Six (33,3%) were taking mycophenolate mofetil and 12 (66.6%) enteric-coated mycophenolate sodium. No significant changes were observed in either hepatic functions, serum lipids, or hemograms. There was no mortality or graft loss. The mean level of serum creatinine was 1.3 ± 0.7 mg/dL before and 1.09 ± 0.6 mg/dL after conversion. Proteinuria observed in only 1 patient was well controlled with angiotensin-converting enzyme inhibitor therapy. All patients responded to statin therapy. One patient developed unilateral lower extremity edema and 1 a lymphocele. Although there were 3 cases (14%) of biopsy-confirmed acute rejection, there was no mortality or graft loss. Everolimus conversion has become an excellent choice, offering safety and efficacy with good outcomes.
    Transplantation Proceedings 04/2013; 45(3):913-6. DOI:10.1016/j.transproceed.2013.02.076 · 0.95 Impact Factor
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    Nida Dincel · Sevgi Mir · Afig Berdeli · Ipek Kaplan Bulut · Betul Sozeri
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    ABSTRACT: Nephrotic syndrome (NS) in the first year of life is uncommon and makes up a heterogeneous group of disorders. Subsequent studies have further defined the phenotype associated with mutations in the NPHS2 gene, revealing that patients usually develop NS from birth to 6 years of age. We report a child aged 4 months with steroid-resistant NS who had polymorphism of NPHS1 (E117K) and mutation of NPHS2 (P118L). Our patient was carrying a polymorphic NPHS1 mutation, while phenotypically she had a poor prognostic NPHS2 mutation. However, it must be questioned whether this polymorphic change (E117K) alters the signaling pathways of the podocytes and leads to P118L mutation, thus making it behave differently. Perhaps, this would be called a genetic modifier in future.
    Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 01/2013; 24(6):1210-1213. DOI:10.4103/1319-2442.121300
  • Ipek Kaplan Bulut · Fatma Mutlubas · Sevgi Mir · Can Balkan
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    ABSTRACT: The Imersland-Gräsbeck Syndrome (IGS) is a rare inherited disorder characterized by megaloblastic anemia due to a selective Vitamin B₁₂ malabsorption in association with mild proteinuria. This syndrome can be diagnosed and treated easily. Herein, we describe an infant with IGS as a rare etiology of growth retardation with diarrhea, vomiting and therapy-resistant proteinuria.
    Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 05/2012; 23(3):569-71.
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    ABSTRACT: Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis. Patients manifest variable clinical symptoms (eg, microhematuria) with preserved or progressive deterioration of renal function resulting in end-stage renal disease. The aim of this study was to evaluate patients from a single center to describe the clinical features, treatments, and follow-up results of those with the disease. This is a retrospective data study of all children with IgAN. Patients who had a histopathologically proven diagnosis of IgAN and were followed up for at least 5 years were included in the study. Renal biopsy, graded as Hass classification, was performed on all patients. A total of 39 patients were included in the study. The mean follow-up time (± standard deviation) was 10.4 ± 3.51 (range 5-16) years. Twenty-nine patients (74.4%) were male and ten (25.6%) were female. Nineteen (48.7%) patients presented with recurrent macroscopic hematuria, ten (25.6%) with microscopic hematuria ± proteinuria, six (15.4%) with nephritic syndrome, and four (10.3%) with nephrotic syndrome. All patients underwent a renal biopsy, which was graded according to the Hass classification. At the end of follow-up time, 18 (46.1%) patients were normal, 15 (38.5%) had minor urinary abnormalities, three (7.7%) had active renal disease, and three (7.7%) developed renal failure. The results of the present study are better than those from most other series. The majority of children with IgAN in this study were admitted with recurrent macroscopic hematuria and found to have a good prognosis. We suggest that children with IgAN have a good prognosis in the first 5-year follow-up period.
    International Journal of Nephrology and Renovascular Disease 01/2012; 5:23-8. DOI:10.2147/IJNRD.S24684
  • 08/2011; 1(2):69-74. DOI:10.5222/buchd.2011.069

Publication Stats

5 Citations
6.31 Total Impact Points

Institutions

  • 2014
    • Zeynep Kamil Women's and Children's Disease Training and Research Hospital
      İstanbul, Istanbul, Turkey
  • 2012–2014
    • Ege University
      • Department of Pediatric Nephrology
      Ismir, İzmir, Turkey