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    Assessment of the oral health status of children with chronic kidney disease
    (Springer Science and Business Media Deutschland GmbH, 2023) Sezer, Berkant; Kaya, Remziye; Kodaman Dokumacıgil, Nur; Sıddıkoğlu, Duygu; Güven, Serçin; Yıldız, Nurdan; Alpay, Harika; Kargül, Betül
    Background There are various oral symptoms related to the disease and its management in individuals with chronic kidney disease (CKD). The aim of the study was to investigate the oral health status of children with different stages of CKD, kidney transplant recipients (KTR), and healthy children. Methods A total of seventy-one children diagnosed with CKD and fifty-two healthy children were included in the study. Each patient was examined for dental caries by the decayed-missing-filled-teeth (DMFT/dmft) index and the International Caries Detection and Assessment System (ICDAS-II), developmental defects of enamel (DDE) by the DDE index, and oral hygiene by the debris (DI), calculus (CI), and simplified oral hygiene (OHI-S) indices. Results The median number of DMFT/dmft was 1.00 (interquartile range (IQR):1.00-4.00) in children with stage 1-3 CKD, 0.00 (IQR: 0.00-2.50) in stage 4-5 children, 0.00 (IQR: 1.00-3.00) in KTR, and 8.00 (IQR: 1.00-13.00) in healthy children. According to ICDAS-II categories, the percentage of children with severe caries was 53.8% in healthy children, while it was 44.4% in KTR, 25.9% in stage 1-3, and 11.4% in stage 4-5 children. While the percentage of children with DDE was 88.8% in KTR, 80% in stage 4-5, and 66.7% in stage 1-3 children, this rate was 44.2% in healthy children. The highest mean OHI-S score was observed in stage 4-5 children (2.10 +/- 1.08), followed by KTR (1.46 +/- 1.19), stage 1-3 (1.27 +/- 0.61), and healthy children (0.45 +/- 0.44), respectively. Conclusions Compared to healthy children, children with CKD had more debris accumulation, calculus formation, and more DDE but a lower severity of dental caries.
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    Association between serum biomarkers and oral health status in children with chronic kidney disease: A cross-sectional study
    (Springer Science and Business Media Deutschland GmbH, 2023) Sezer, Berkant; Kodaman Dokumacıgil, Nur; Kaya, Remziye; Güven, Serçin; Türkkan, Özde Nisa; Çiçek, Neslihan; Alpay, Harika; Kargül, Betül
    Objectives: The aim of this study was to investigate the association between serum biomarkers and oral health parameters in children with chronic kidney disease (CKD). Materials and methods: Serum hemoglobin, blood urea nitrogen, serum creatinine, calcium, parathormone, magnesium, and phosphorus levels were measured in 62 children with CKD aged between 4 and 17 years. Intraoral examinations of the patients were performed by two different pediatric dentists. Dental caries was assessed using the decayed-missing-filled-teeth (DMFT/dmft) indexes, and oral hygiene was assessed using the debris (DI), calculus (CI), and simplified oral hygiene (OHI-S) indexes. Spearman’s rho coefficient and generalized linear modeling were used to examine the association between serum biomarkers and oral health parameters. Results: The results of the study showed that there were negative and statistically significant correlations between serum hemoglobin and creatinine levels and dmft scores in pediatric patients with CKD (p = 0.021 and p = 0.019, respectively). Furthermore, blood urea nitrogen levels and DI and OHI-S scores (p = 0.047 and p = 0.050, respectively); serum creatinine levels and DI, CI, and OHI-S scores (p = 0.005, p = 0.047, p = 0.043, respectively); and parathormone levels and CI and OHI-S scores (p = 0.001 and p = 0.017, respectively) were found to be positively and statistically significantly related. Conclusions: There are associations between various serum biomarker levels and dental caries and oral hygiene parameters in pediatric patients with CKD. Clinical relevance: The impact of changes in serum biomarkers on oral and dental health is important for dentists’ and medical professionals' approaches to patients' oral and systemic health.
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    Dental caries, oral hygiene and salivary characteristics in children with chronic kidney disease: a case-control study
    (Springer, 2025) Dokumacigil, Nur Kodaman; Sezer, Berkant; Oktay, Sehkar; Alpay, Harika; Kargul, Betul
    Background The aim of this study was to compare the oral health findings and salivary parameters of children with different stages of chronic kidney disease (CKD) with those of healthy peers. Methods Intraoral examinations were performed on 43 children aged 8-17 years with CKD and 40 healthy controls from the same pediatric nephrology clinic. Oral health was assessed using the DMFT/dft indices (decayed-missing-filled-teeth), debris index (DI), calculus index (CI), and simplified oral hygiene index (OHI-S). Saliva samples from the children were analyzed for salivary flow rate (SFR), pH, buffering capacity (BC), total oxidant status (TOS), total antioxidant capacity (TAOC), urea, creatinine (Cr), calcium (Ca), potassium (K), phosphorus (P), and salivary alpha-amylase (SAA). Spearman's rho coefficient was used to examine the relationship between salivary and serum biomarkers levels and oral health findings.ResultsWhile the DMFT/dft scores were lower in children with CKD (p = 0.001), DI, CI, and OHI-S scores were higher in healthy peers (p < 0.001). Children with CKD had lower SFR, Ca, and TAOC levels, and higher BC, pH, urea, Cr, K, P, TOS, and SAA levels (p < 0.001) compared to healthy controls. Later stages of CKD was associated with the lower dft ( rs= - 0.35; p = 0.022). ConclusionsChildren with CKD exhibit fewer caries and poorer oral hygiene compared to their healthy peers, and their saliva characteristics differ significantly from those of the healthy group. Disease-related changes in serum and salivary character-istics affect the oral health of children with CKD, necessitating collaboration between pediatric nephrologists and dentists.Trial registrationClinicalTrials.gov (NCT06578832).
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    The relationship between urine heat shock protein 70 and congenital anomalies of the kidney and urinary tract: UTILISE study
    (Frontiers Media Sa, 2024) Aksu, Bagdagul; Afonso, Alberto Caldas; Akil, Ipek; Alpay, Harika; Atmis, Bahriye; Aydog, Ozlem; Bakkaloglu, Sevcan
    Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are defined as structural malformations of the kidney and/or urinary tract. Heat shock proteins (HSPs) are expressed in the kidney in response to cellular changes, such as thermal, hemodynamic, osmotic, inflammatory, and mechanical stresses. This study aimed to assess uHSP70 levels during acute urinary tract infections (UTI) and non-infection periods in patients with CAKUT, and to evaluate whether uHSP70 is elevated in CAKUT subtypes. Methods: Among patients with CAKUT, 89 patients with UTI (CAKUT-A), 111 without UTI (CAKUT-B), and 74 healthy children were included in the study. uHSP70 levels were measured using enzyme-linked immunosorbent assay (ELISA). Results: uHSP70 level was significantly higher in the CAKUT-A group than in the CAKUT-B and healthy control groups (p < 0.0001). Moreover, the level of uHSP70 was significantly higher in the CAKUT-B group than in the control group (p < 0.0001), but was not different between the CAKUT subtypes (p > 0.05). Conclusion: Urine HSP70 can also be used to predict UTI in patients with CAKUT. Moreover, uHSP70 levels were higher in children with CAKUT during the non-infectious period than in healthy controls. This suggests that children with CAKUT are at risk of chronic non-infectious damage.