Augustina Jankauskiene

Vilnius University Children’s Hospital, Vil'nyus, Vilniaus Apskritis, Lithuania

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Publications (16)23.37 Total impact

  • Augustina Jankauskiene, Inga Buteikiene
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    ABSTRACT: Chemosis is a rare and reversible complication of nephrotic syndrome in children. However, it is not a threatening condition as there are no complications of its own. We report a 15-year-old girl with steroid-resistant nephrotic syndrome with bilateral chemosis recovering along with the disappearance of the anasarca.
    European Journal of Pediatrics 04/2009; 168(4):507-8. · 1.98 Impact Factor
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    ABSTRACT: The aim of the study was to evaluate the causes, prevalence, and grades of chronic renal failure in Lithuanian children and to assess its influence on children's growth. The study was performed in Vilnius University Children's Hospital and Clinic of Children's Diseases, Kaunas University of Medicine. By March 31, 2006, 65 children with chronic renal failure had been registered. The prevalence was 88.3 cases per million children. The mean age was 10.8+/-4.9 years. The leading causes of chronic renal failure were congenital diseases (37%) and obstruction with interstitial nephritis (33.8%). At presentation, 23 (35.40%) children had mild, 17 (26.15%) had moderate, 9 (23.85%) had severe renal failure, and 16 (24.6%) had end-stage renal disease. Fourteen (21.54%) children were below the third percentile in height for their age. Growth failure was observed in one (4.35%) child with Grade 1 renal failure. The deterioration of renal function had a significant influence on growth impairment, and 13 (30.95%) children with glomerular filtration rate of less than 60 mL/min/1.73 m2 and 7 (43.75%) with end-stage renal disease had a height below the third percentile. Growth retardation as one of the symptoms of impairment of children's physical development depends on the severity of renal function.
    Medicina (Kaunas, Lithuania) 02/2007; 43 Suppl 1:11-5. · 0.55 Impact Factor
  • Augustina Jankauskiene, Birute Pundziene, Renata Vitkevic
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    ABSTRACT: During the period of 1995-2004, acute postinfectious glomerulonephritis was diagnosed in 322 children aged 1-16 years. An outbreak of acute postinfectious glomerulonephritis was registered in 1995, with a prevalence of 8.3 cases per 100,000 children; during 2003-2004 prevalence decreased and it was 2.2-2.4 cases per 100,000 children. Acute postinfectious glomerulonephritis was most frequently caused by upper respiratory tract infection (28.3%), following by tonsillitis (24%) and skin infection (24%). The mean interval between diagnosis of primary infection and onset of acute postinfectious glomerulonephritis was 14 days and did not differ by infection. The disease was more common in autumn (96 of the 322 cases, P<0.05). There were 4.3% of familial cases; no relapses occurred. Edema was observed in 70.3% of patients; 55.5% had elevated blood pressure according to their age. There were no proteinuria and hematuria in 17.6% and 1.7% of patients, respectively. Short-term renal failure was diagnosed in 32.9% of patients; in two cases, acute renal failure was severe and hemodialysis was started. No patient died.
    Medicina (Kaunas, Lithuania) 01/2007; 43 Suppl 1:16-22. · 0.55 Impact Factor
  • Petras Kaltenis, Augustina Jankauskiene
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    ABSTRACT: Hereditary nephrogenic diabetes insipidus is a rare disease. We describe here three brothers with this disease from a big family consisting of 10 siblings. The case is undoubtedly X-linked because the sufferers are only boys, one of them with a different father. The illness was noticed rather late, namely, at the ages of approximately 7, 6 and 5 years. Possibly, this is a particular characteristic of this family, because the disease is usually diagnosed before the age of two years. In the oldest brother (at present 15 years old) epicystotomy was performed at the time of diagnosis because of polyuria, hydroureteronephrosis and bladder hypotonia; the intervention caused a urinary tract infection leading to chronic pyelonephritis and renal scarring. No urologic intervention was necessary in the younger brothers, because their illness was noticed and treatment started somewhat earlier. This case shows that polydipsia and polyuria should always be assessed properly to disclose their causes.
    Medicina (Kaunas, Lithuania) 02/2006; 42(2):137-41. · 0.55 Impact Factor
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    ABSTRACT: The aim of the study was to evaluate the effects of early treatment with the angiotensin-converting enzyme inhibitor, enalapril, on the blood pressure and left ventricular diameters and function in children suffering from acute postinfectious glomerulonephritis. A total of 51 children with acute postinfectious glomerulonephritis were involved in the study. Out of them, 26 patients were treated with enalapril for 6 weeks, 25 patients served as their controls. Their blood pressure was measured every other day in the early course of the disease, after 6-8 weeks, and after 6 months. 2D, M-mode, pulsed-wave Doppler echocardiography were performed on 18 enalapril treated patients and 14 controls on admission to the hospital and after 6-8 weeks. An earlier decline in blood pressure was found in the enalapril treated patients, with no difference between the groups at 6 months after onset of acute postinfectious glomerulonephritis. Comparison of the echocardiographic findings at the onset of acute postinfectious glomerulonephritis and after 6-8 weeks of enalapril treatment showed a significant decrease of left ventricular end-diastolic diameter (4.42+/-0.71 cm before treatment vs. 4.19+/-0.69 after treatment, p<0.001), left ventricular end-systolic diameter (2.81+/-0.59 cm vs. 2.64+/-0.48 cm, respectively, p=0.04), left ventricular mass (102.56+/-51.86 g vs. 86.77+/-43.54 g, p<0.001), and mitral peak flow velocity of late filling (0.54+/-0.11 m/s vs. 0.49+/-0.09 m/s, p=0.02). Other parameters, although statistically nonsignificant, showed better improvement in the enalapril treated patients than in those untreated. In the enalapril untreated group, echocardiographic parameters did not change significantly. A better antihypertensive effect was found in the enalapril treated patients, as well as better improvement of echocardiographic parameters, early in the disease. Whether these effects of enalapril have some influence on the outcome of acute postinfectious glomerulonephritis requires further study.
    Medicina (Kaunas, Lithuania) 01/2005; 41(12):1019-25. · 0.55 Impact Factor
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    ABSTRACT: The aim of the study was to assess left ventricular (LV) geometry in children with chronic renal insufficiency (CRI), and its relationship with glomerular filtration rate (GFR) and preexisting renal disease. Echocardiography was performed on 56 non-dialysed CRI patients and 56 controls. CRI patients had bigger interventricular septum thickness (0.77+/-0.17 vs. 0.67+/-0.12 cm, p=0.002), LV posterior wall thickness (0.79+/-0.14 vs. 0.71+/-0.14 cm, p<0.006), LV mass index (LVMI) (40.7+/-12.2 vs. 31.7+/-6.3 g/m2.7, p<0.0001; 86.4+/-24.1 vs. 69.1+/-13.9 g/m2, p<0.0001), and relative wall thickness (0.38+/-0.05 vs. 0.34+/-0.04, p<0.0001) in comparison with controls. Twenty (36%) of CRI patients had LV hypertrophy (LVH). Thirteen patients (23%) had eccentric LVH, 7 (13%)-concentric LVH), and 9 (16%) of patients-concentric LV remodeling. No significant difference was found between LV parameters in patient groups with different GFR. Patients with acquired renal diseases and hereditary nephropathies had significantly higher LVMI than patients with congenital renal abnormalities. Our results indicate that changes of LV geometry are present in children with mild, moderate and predialysis CRI. These findings support the concept of cardiovascular disease risk for patients with different stages of CRI.
    Medicina (Kaunas, Lithuania) 01/2005; 41 Suppl 1:5-11. · 0.55 Impact Factor
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    ABSTRACT: Constitutional missense mutations in the WT1 gene are usually associated with the Denys-Drash syndrome, characterized by a rapid progressive nephropathy, male pseudohermaphroditism, and an increased risk for Wilms tumor. We report here a patient with scrotal hypospadias and a slow progressive nephropathy due to focal and segmental glomerulosclerosis. WT1 mutation analysis revealed a constitutional missense mutation in exon 9 resulting in an exchange F392L. This mutation has previously been reported by others in a patient with a similar mild course of nephropathy. In contrast, a mutation in the corresponding codon of exon 8 (F364L) was previously found by us in a patient with a very rapid progression to end-stage renal disease. Whether the position of a mutation may influence the course of the nephropathy must be evaluated in a larger patient cohort. The individual tumor risk for this alteration cannot be given at present because neither of the two patients has shown evidence of a Wilms tumor or a gonadoblastoma to date.
    Pediatric Nephrology 04/2004; 19(3):353-6. · 2.94 Impact Factor
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    Nephrology Dialysis Transplantation 12/2003; 18(11):2456-7. · 3.37 Impact Factor
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    ABSTRACT: There are many studies about heart dysfunction and its significance in chronic renal diseases, but only few data regards cardiac involvement in acute glomerular diseases. The aim of this study was to assess echocardiographic changes in children with acute postinfectious glomerulonephritis (APGN), and the relationship of those changes to blood pressure (BP), edema and glomerular filtration rate (GFR). Echocardiography was performed on 127 patients on admission to the hospital, on a random sample consisting of 51 patients after 6-8 weeks, and 124 controls. In the acute phase, APGN patients had a greater left ventricular (LV) internal end-diastolic diameter (LVIDd) (P=0.022), interventricular septum thickness (IVSd) (P=0.038), LV mass (LVM) (P=0.0001), longer early diastolic flow deceleration time (DT) (P=0.0001), and higher numbers of cases with mitral regurgitation (MR) (P=0.0001) and pericardial effusion (P=0.0001) in comparison with the controls. Changes were more evident in the youngest patients. At follow-up after 6-8 weeks, echocardiographic parameters significantly improved, but LV posterior wall thickness, IVSd, LV end-diastolic volume, LVM and DT remained greater than in the controls. GFR and edema influenced echocardiographic parameters. In conclusion, in a group of children ill with APGN, increases in left ventricular dimensions, wall thickness, LVM and changes in the left ventricular diastolic function related to edema and GFR were found. Whether different treatment regimens effect these changes requires further study.
    European Journal of Pediatrics 08/2003; 162(7-8):500-5. · 1.98 Impact Factor
  • Vytautas Baciulis, Augustina Jankauskiene, Rimante Cerkauskiene
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    ABSTRACT: The aim of this study was to find out the clinical aspects of peritonitis and catheter exit site infection in children undergoing continuous cyclic peritoneal dialysis. The incidence of peritonitis and catheter related infections were reviewed in 8 children on continuous cyclic peritoneal dialysis over a mean period of 14.9+/-15.8 months. Peritonitis occurred in 4 children. There were 14 episodes of peritonitis. The mean time from starting dialysis to the first episode of peritonitis was 1.9+/-1.0 months. The incidence of peritonitis was 1 episode in 9 treatment months. Gram-negative organisms (Enterococcus spp.) were responsible for the majority of episodes (35.7%) of peritonitis and gram-positive bacteria mainly caused the catheter exit site infections (Staphylococcus epidermidis). The incidence of catheter exit site infection was one episode in 8 treatment months. Recurrent peritonitis was present in 1 case. Most patients with dialysis-related peritonitis and catheter exit site infection responded to antibiotic therapy. Catheter was replaced in 2 patients. The mortality rate was 2 out of 8 patients but none of the deaths were related to peritonitis. Patients with exit site infection had 7 times higher risk than those without developing peritonitis.
    Medicina (Kaunas, Lithuania) 02/2003; 39 Suppl 1:70-4. · 0.55 Impact Factor
  • Augustina Jankauskiene, Marija Jakutovic
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    ABSTRACT: For the first time neonatal variant of Bartter syndrome to 14.5-year old girl is presented in Lithuania. It is a rare genetical disease with autosomal recessive inheritance. The patient was born prematurely, had polyhydramnion, polyuria and polydypsia, a craving for salt, specific outlook and was mentally retarded, had muscle weakness and nephrocalcinosis. Hypokalemia, hyperreninemia and metabolic alkalosis were found. Urine analysis revealed impaired renal concentration capacity, hypercalciuria and hypernatriuria. She had the symptom of systemic disease - osteopenia. Literature review on Bartter's syndrome is done.
    Medicina (Kaunas, Lithuania) 02/2003; 39 Suppl 1:88-93. · 0.55 Impact Factor
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    ABSTRACT: The aim of the study was to evaluate the efficacy and safety of low-dose, long-term cefadroxil prophylaxis in preventing recurrent urinary tract infections in children. A prospective, randomized trial in 33 children (32 female, 1 male) aged 2-14 years (mean 8.1+/-2.8) was conducted. Children with recurrent urinary tract infections were commenced to six-month prophylaxis with cefadroxil at the dosage of 12.5-15.0 mg/kg at bedtime administered every night (group I, n=15) or alternate night (group II, n=18). Escherichia coli was the most frequently isolated agent (90.9%), followed by Proteus mirabilis (3.0%) and Klebsiella oxytoca (3.0%) and Staphylococcus epidermidis (3.0%). Cefadroxil prophylaxis was effective in 80% of patients in group I and in 78% patients in group II. Reinfection occurred in 3/15 (20%) patients in-group I and in 4/18 (22.2%) patients in-group II (odds ratio--1.14; 95% confidence interval--0.16-8.3). The difference of reinfection rate between the groups was not significant (p=0.88). The rate of day- and night-time wetting in both groups before prophylaxis of urinary tract infections was high. It decreased significantly at the end of prophylactic treatment with cefadroxil (from 42.4% to 9.1% and from 39.4% to 6.1% respectively). Mild adverse reaction (nausea) was observed in 1/33 patient. In conclusion our study shows that cefadroxil is an effective, well-tolerated and safe agent in the urinary tract infections prophylaxis. Prophylaxis of recurrent urinary tract infections in children with cefadroxil on alternate night regimen might reduce the cost of the treatment.
    Medicina (Kaunas, Lithuania) 02/2003; 39 Suppl 1:59-63. · 0.55 Impact Factor
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    Petras Kaltenis, Rimantë Èerkauskienë, Augustina Jankauskienë
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    ABSTRACT: Glomerulonephritis is a rare complication of varicella. Even less com-mon is concurrent appearance of varicella, streptococcal infection and glomerulonephritis. We present a 9-year old boy who developed a typi-cal varicella rash and signs and symptoms of glomerulonephritis simul-taneously, followed shortly after by tonsillopharyngitis. The supervenient illness did not aggravate the clinical course of the renal disease and had no detrimental influence on the laboratory findings. Thus, coincidence of varicella and streptococcal infection appears not to change the clini-cal course and the outcome of glomerulonephritis.
    01/2003;
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    ABSTRACT: The objective of this study was to determine whether nitrofurantoin, used for long-term antimicrobial prophylaxis of urinary tract infection, may induce chromosome aberrations (CAs) and sister chromatid exchanges (SCEs) in lymphocytes of treated children. Ninety-nine blood samples were taken from 69 children aged from 0.2 to 13 years and suffering from urinary tract infection. The treatment consisted of oral administration of nitrofurantoin at doses of 5-8 mg/kg/day for the first 7 days and at doses of 1-2 mg/kg/day for the rest of the treatment period. Blood was sampled before the start of the nitrofurantoin therapy and after 1, 3, 6 and 12 months of the therapy. Analysis of variance showed no statistically significant increase in CA and SCE frequencies in lymphocytes of children treated with nitrofurantoin for 1-12 months. However, a significant increase in SCE rates was determined in lymphocytes of those patients whose blood samples were available both before and after treatment with nitrofurantoin (6.21 +/- 0.28 and 7.30 +/- 0.39 SCE/cell, respectively, P = 0.0315, Student's paired t-test). Moreover, there was a statistically significant correlation (r = 0.6603, P = 0.0270) between cumulative dose of nitrofurantoin and SCE frequency in lymphocytes of children after 1 month of the therapy. Also, in vitro experiments indicated that nitrofurantoin was able to induce both CAs and SCEs in human lymphocytes. Positive findings with chromosome aberrations and SCEs in vitro and suggestive results with SCEs in vivo indicate that further, much larger follow-up studies are needed to elucidate the genetic safety of the therapeutic use of nitrofurantoin.
    Mutagenesis 02/2002; 17(1):31-5. · 3.50 Impact Factor
  • A Jankauskiene, V Druskis, A Laurinavicius
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    ABSTRACT: A case report on the nephrotoxic effect of cyclosporine in a 9-year-old boy with a kidney transplant is presented. Nephrotoxicity was present even at low trough cyclosporine concentration. The literature on the range of cyclosporine nephrotoxicity is reviewed. Cyclosporine (CsA), a fungal decapeptide first introduced in 1983, has significantly improved the outcome of renal transplantation, and remains the first line immunosupressant for pediatric recipients. CsA has a narrow therapeutic range because of the fine line between adequate immunosuppression and the risk of drug-induced side effects. Furthermore, considerable inter- and intrapatient variability does exist [Filler et al. 1999]. The pre-dose trough concentration is routinely used for therapeutic drug monitoring [Bunchman et al. 1998]. The most significant side effect is nephrotoxicity, which may present differently at different times after transplantation. Renal vasoconstriction, especially involving the afferent renal arterioles, has been strongly implicated as a primary factor in acute reversible CsA nephrotoxicity. Alpha-adrenergic and calcium channel blockade with either verapamil or nifedipine ameliorates vasospasm and impairment of renal function that accompany CsA toxicity. Because of this vasoconstrictive effect, CsA may increase ischemic graft damage in the early posttransplant period. CsA side effects can be eliminated by reducing the dosage of the drug. We present an unusual case of nephrotoxicity and impaired renal function with a very low CsA blood trough concentration (50 ng/ml) on posttransplant treatment. The side effects subsided only after the discontinuation of CsA.
    Clinical nephrology 01/2002; 56(6):S27-9. · 1.29 Impact Factor
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    ABSTRACT: Cytogenetic analysis of chromosome aberrations (CAs) and sister chromatid exchanges (SCEs) was performed in 109 blood samples from 95 pediatric patients with urinary tract infections (UTIs). Children were exposed to diagnostic levels of X-rays during voiding cystourethrography and subsequently treated for one to 12 months with low doses of furagin - N-(5-nitro-2-furyl)-allylidene-1-aminohydantoin. Furagin is 2-substituted 5-nitrofuran, chemically and structurally similar to well-known antibacterial compound nitrofurantoin. Increased frequencies of CAs were found in children undergoing voiding cystourethrography as compared with the unexposed, acentric fragments being the most frequent alteration (2.03 versus 0.88 per 100 cells, P=0.006). However, a significant decrease in the frequency of acentric fragments was determined with the time elapsed since X-ray examination was performed. A time-independent increase in SCE frequency was found in lymphocytes of children treated with furagin. Total CA frequency did not differ significantly between groups of children with various duration of furagin treatment. However, frequency of chromatid exchanges (triradials and quadriradials) increased significantly with duration of treatment.
    Mutation Research/Fundamental and Molecular Mechanisms of Mutagenesis 05/2001; 491(1-2):25-30. · 3.90 Impact Factor

Publication Stats

40 Citations
23.37 Total Impact Points

Institutions

  • 2003–2009
    • Vilnius University Children’s Hospital
      Vil'nyus, Vilniaus Apskritis, Lithuania
  • 2002–2009
    • Vilnius University
      • Vaikų ligų klinika
      Vil'nyus, Vilniaus Apskritis, Lithuania