Our interventional study revealed the favorable effects of high-dose cholecalciferol on cardiovascular and endothelial parameters, implying the importance of vitamin D supplementation in children with CKD.

Cardiovascular factors are an important cause of mortality in chronic kidney disease, and vitamin-D deficiency is common in this patient population. Therefore, we aimed to investigate the effect of oral cholecalciferol on cardiac mechanics in children with chronic kidney disease. A total of 41 children with chronic kidney disease - the patient group - and 24 healthy subjects - the control group - free of any underlying cardiac or renal disease with low 25-hydroxyvitamin-D3 levels were evaluated by conventional tissue Doppler imaging and two-dimensional speckle-tracking echocardiography, both at baseline and following Stoss vitamin-D supplementation. Left ventricular strain and strain rate values were compared between the study groups. Initial longitudinal and radial strain as well as strain rate values of the left ventricle were significantly lower in patients. After vitamin-D supplementation, these improved significantly in patients, whereas no significant change was observed in the control group. Our study showed that, although conventional and tissue Doppler imaging methods could not determine any effect, two-dimensional speckle-tracking echocardiography revealed the favourable effects of high-dose cholecalciferol on cardiac mechanics, implying the importance of vitamin-D supplementation in children with chronic kidney disease.

Objective: The aim of this retrospective study was to evaluate demographic, etiologic and epidemiologic characteristics, and clinical and laboratory findings of Henoch-Schonlein purpura (HSP) and to determine risk factors increasing the kidney involvement in our region.Materials and Methods: Records of 151 patients who were followed-up with the diagnosis of HSP between May 2002 and December 2010 in the Department of Child Nephrology in Kocaeli University Medical Faculty and fulfilled the inclusion criteria were retrospectively evaluated. Demographic characteristics of the patients, season of presentation, complaints on admission, triggering factors, pathological examination, laboratory data, and the duration of follow-up periods were assessed.Results: Of 151 patients, 90 (60%) were male and 61 (40%) were female. The mean age was 7.4±3.4 years (range, 1.8-16.5 years). While 33 (22%) patients did not have purpuric rash on admission, they were then observed to have purpuric rash during the follow-ups. Increasing age was found to be a risk factor for kidney involvement (p=0.011). Testicular involvement was identified as a negative risk factor for kidney involvement (p=0.020). Factors such as gender, GIS and musculoskeletal system involvement, recurrence, and steroid treatment were not found to be associated with kidney involvement. Conclusion:Etiologic, epidemiologic, and clinical findings of HSP patients in our region were found to be similar to those reported in the national and international studies. In parallel to the literature, the present study showed an increased risk of kidney involvement with increasing age.

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Background Automated peritoneal dialysis (APD) is increasingly preferred worldwide. By using a software application (Homechoice with Claria sharesource system (CSS)) with a mod-M added to the APD device, details of the home dialysis treatment become visible for PD nurses and physicians, allowing for close supervision. We aimed to evaluate the perceptions of patients/caregivers, PD nurses, and physicians about the advantages and disadvantages of CSS. Methods Three different web-based questionnaires for patients/caregivers, nurses, and physicians were sent to 15 pediatric nephrology centers with more than 1 year of experience with CSS. Results Respective questionnaires were answered by 30 patients/caregivers, 22 pediatric nephrologists, and 15 PD nurses. Most of the nurses and physicians (87% and 73%) reported that CSS improved patient monitoring. A total of 73% of nurses suggested that CCS is not well known by physicians, while half of them reported reviewing CSS data for all patients every morning. Sixty-eight percent of physicians thought that CSS helps save time for both patients/caregivers and healthcare providers by reducing visits. However, only 20% of patients/caregivers reported reduced hospital visits. A total of 90% of patients/caregivers reported that being under constant monitoring made them feel safe, and 83% stated that the patient’s sleep quality improved. Conclusions A remote monitoring APD system, CSS, can be successfully applied with children for increased adherence to dialysis prescription by giving shared responsibility and may help increase the patient’s quality of life. This platform is more commonly used by nurses than physicians. Its potential benefits should be evaluated in further well-designed clinical studies with larger patient groups. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information . Supplementary Information The online version contains a graphical abstract available at 10.1007/s00467-022-05563-9.