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Article ; Online: Henoch-Schönlein purpura nephritis in children: risk factors, prevention and treatment.

Bogdanović, Radovan

Acta paediatrica (Oslo, Norway : 1992)

2009 Volume 98, Issue 12, Page(s) 1882–1889

Abstract: Aim: To identify risk factors for a child with Henoch-Schönlein purpura (HSP) either to develop nephritis (HSPN) or to contract progressive course and to obtain the currently available evidence on the efficacy of treatment options in both preventing and ...

Abstract	Aim: To identify risk factors for a child with Henoch-Schönlein purpura (HSP) either to develop nephritis (HSPN) or to contract progressive course and to obtain the currently available evidence on the efficacy of treatment options in both preventing and treating the established renal disease. Method: Review of the literature published over the last two decades. Results: Persistent or recurrent purpura, severe abdominal symptoms and an older age proved as the most significant risk factors for later HSPN. The risks of long-term renal impairment are the highest in children having at presentation nephritic/nephrotic syndrome and/or more than 50% of glomeruli occupied by large crescents or sclerosing lesions. Randomized controlled trials (RCT) do not support short course prednisone at presentation of HSP in preventing persistent renal disease. Many uncontrolled studies using various treatment regimens have reported outcomes considered better than expected. However, the data from RCTs are sparse and no treatment options for the established renal disease can be currently recommended based on RCTs. Conclusion: Severity and/or duration of extrarenal HSP symptoms and an older age are the most significant risk factors for developing HSPN, whereas clinical and histological severity at HSPN onset are in general predictive of a long-term renal impairment. The existing evidence does not support of short course prednisone in preventing persistent renal disease. A well-designed RCTs are needed in children with moderately severe or rapidly progressive (crescentic) HSPN.
MeSH term(s)	Child ; Humans ; Nephritis/etiology ; Nephritis/prevention & control ; Nephritis/therapy ; Purpura, Schoenlein-Henoch/complications ; Randomized Controlled Trials as Topic ; Risk Factors ; Treatment Outcome
Language	English
Publishing date	2009-12
Publishing country	Norway
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	203487-6
ISSN	1651-2227 ; 0365-1436 ; 0803-5253
ISSN (online)	1651-2227
ISSN	0365-1436 ; 0803-5253
DOI	10.1111/j.1651-2227.2009.01445.x
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Article: Diabetic nephropathy in children and adolescents.

Bogdanović, Radovan

Pediatric nephrology (Berlin, Germany)

2007 Volume 23, Issue 4, Page(s) 507–525

Abstract: Type 1 diabetes mellitus (T1DM) commonly occurs in childhood or adolescence, although the rising prevalence of type 2 diabetes mellitus (T2DM) in these age groups is now being seen worldwide. Diabetic nephropathy (DN) develops in 15-20% of subjects with ... ...

Abstract	Type 1 diabetes mellitus (T1DM) commonly occurs in childhood or adolescence, although the rising prevalence of type 2 diabetes mellitus (T2DM) in these age groups is now being seen worldwide. Diabetic nephropathy (DN) develops in 15-20% of subjects with T1DM and in similar or higher percentage of T2DM patients, causing increased morbidity and premature mortality. Although overt DN or kidney failure caused by either type of diabetes are very uncommon during childhood or adolescence, diabetic kidney disease in susceptible patients almost certainly begins soon after disease onset and may accelerate during adolescence, leading to microalbuminuria or incipient DN. Therefore, all diabetics warrant ongoing assessment of kidney function and screening for the earliest manifestations of renal injury. Pediatric health care professionals ought to understand about risk factors, strategy for prevention, method for screening, and treatment of early DN. This review considers each form of diabetes separately, including natural history, risk factors for development, screening for early manifestations, and strategy recommended for prevention and treatment of DN in children and adolescents.
MeSH term(s)	Adolescent ; Child ; Child, Preschool ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/pathology ; Diabetes Mellitus, Type 1/therapy ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/pathology ; Diabetes Mellitus, Type 2/therapy ; Diabetic Nephropathies/etiology ; Diabetic Nephropathies/pathology ; Diabetic Nephropathies/prevention & control ; Humans ; Mass Screening ; Risk Factors
Language	English
Publishing date	2007-10-17
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	631932-4
ISSN	1432-198X ; 0931-041X
ISSN (online)	1432-198X
ISSN	0931-041X
DOI	10.1007/s00467-007-0583-2
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Article ; Online: Evaluation of carotid intima media thickness in children with idiopathic nephrotic syndrome.

Paripović, Aleksandra / Stajić, Nataša / Putnik, Jovana / Gazikalović, Ana / Bogdanović, Radovan / Vladislav, Vukomanović

Nephrologie & therapeutique

2020 Volume 16, Issue 7, Page(s) 420–423

Abstract: Aim: Aim of the study was to determine if carotid intima media thickness in children with idiopathic nephrotic syndrome is greater than in healthy subjects, and to assess whether carotid intima media thickness in children with nephrotic syndrome is ... ...

Abstract	Aim: Aim of the study was to determine if carotid intima media thickness in children with idiopathic nephrotic syndrome is greater than in healthy subjects, and to assess whether carotid intima media thickness in children with nephrotic syndrome is associated with clinical (including disease duration, cumulative dose of steroids, number of relapses) and biochemical parameters. Methods: A cross-sectional study included 40 patients with nephrotic syndrome (mean age 11.7±4.7 years). Steroid dependent nephrotic syndrome was established in 32 patients (80%), while 8 (20%) had steroid resistant nephrotic syndrome. Control group consisted of 20 age and gender matched healthy children. Blood pressure based on 24-h ambulatory blood pressure monitoring (ABPM), carotid intima media thickness, fasting glucose, insulin, HbA1c, lipid concentrations were measured in all children. Results: A significant difference was detected in carotid intima media thickness values (P=0.036). Children with nephrotic syndrome had significantly greater carotid intima media thickness compared with healthy children (0.42±0.06 and 0.38±0.03mm). Carotid intima-media thickness was positively associated with duration of nephrotic syndrome (r=0.45; P=0.004), body mass index (r=0.48; P=0.002), daytime systolic blood pressure (r=0.46; P=0.003) and night-time systolic blood pressure (r=0.52; P=0.001). Multiple linear regression showed that duration of nephrotic syndrome was the only independent predictor of carotid intima media thickness in children with nephrotic syndrome (R Conclusion: The findings of the present study suggest subclinical vascular damage in patients with nephrotic syndrome. Duration of nephrotic syndrome was the only independent predictor of carotid intima media thickness.
MeSH term(s)	Blood Pressure ; Body Mass Index ; Carotid Intima-Media Thickness ; Case-Control Studies ; Child ; Cross-Sectional Studies ; Female ; Humans ; Male ; Nephrotic Syndrome/complications ; Systole
Language	English
Publishing date	2020-11-06
Publishing country	France
Document type	Journal Article
ZDB-ID	2229575-6
ISSN	1872-9177 ; 1769-7255
ISSN (online)	1872-9177
ISSN	1769-7255
DOI	10.1016/j.nephro.2020.09.004
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Article ; Online: The Child Health Care System of Serbia.

Bogdanović, Radovan / Lozanović, Dragana / Pejović Milovančević, Milica / Sokal Jovanović, Ljiljana

The Journal of pediatrics

2016 Volume 177S, Page(s) S156–S172

Abstract: The health care system in Serbia is based on a network of public health institutions funded by the National Health Insurance and from the state budget. Access to public health institutions is free. Preventive and curative services are provided at the ... ...

Abstract	The health care system in Serbia is based on a network of public health institutions funded by the National Health Insurance and from the state budget. Access to public health institutions is free. Preventive and curative services are provided at the local level in primary health care centers. Over the past 5-7 years, the number of pediatricians in primary health care centers decreased because of reduced number of applicants for pediatric training, which endangers the maintenance of the traditional model of pediatric care. Secondary medical care is offered in pediatric departments of local and regional general hospitals or outpatient clinics, and in specialized hospitals for children or adults. Tertiary medical care is provided by inpatient or outpatient subspecialty services in 5 major university children's clinics. The health reforms undertaken in the recent 10 years have aimed at strengthening preventive health care and reducing the overall costs for pediatric care. Current initiatives of the Ministry of Health and national pediatric associations are aimed at reestablishing and strengthening the capacity of the primary pediatric health care model by increasing the number of physicians and developing new processes of care.
MeSH term(s)	Adolescent ; Child ; Child Health ; Child Health Services ; Child, Preschool ; Female ; Humans ; Male ; Serbia
Language	English
Publishing date	2016-09-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/j.jpeds.2016.04.053
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Article ; Online: Frasier syndrome diagnosed in a 4-year-old girl

Miloševic Biljana / Bogdanović Radovan / Kostić Mirjana / Stojanović Vesna

Open Medicine, Vol 7, Iss 2, Pp 142-

2012 Volume 144

Keywords	frasier syndrome ; rare mutation ; post-transplantation lymph-proliferative disease ; Medicine ; R
Language	English
Publishing date	2012-04-01T00:00:00Z
Publisher	De Gruyter
Document type	Article ; Online
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Article ; Online: Chronic kidney disease during a 12-year period at tertiary health institution

Paripović Aleksandra / Stajić Nataša / Putnik Jovana / Bogdanović Radovan

Srpski Arhiv za Celokupno Lekarstvo, Vol 140, Iss 5-6, Pp 313-

2012 Volume 320

Abstract: Introduction. Chronic kidney disease (CKD) is a significant cause of morbidity and mortality in paediatric population. Objective. The aim of the study was analysis of aetiology, staging and associated complications of CKD at the time of diagnosis. ... ...

Abstract	Introduction. Chronic kidney disease (CKD) is a significant cause of morbidity and mortality in paediatric population. Objective. The aim of the study was analysis of aetiology, staging and associated complications of CKD at the time of diagnosis. Methods. Data of 97 patients (56 boys) of average age 7.8±5.8 years, referred for the first time to the Institute for Mother and Child Healthcare „Dr Vukan Čupić”, Belgrade in the period 1998- 2009, due to CKD, stage 2-5, were analysed. In each patient illness history was obtained, and physical examination, laboratory, X-ray and other investigations were performed according to the indications. CKD was classified according to the glomerular filtration rate into four grades: 2 - mild (60-90 ml/min/1.73 m2); 3 - moderate (30-60 ml/min/1.73 m2); 4 - advanced (15-30 ml/ min/1.73 m2); and 5 - terminal (<15 ml/min/1.73 m2). Results. The most frequent causes of CKD were congenital anomalies of the kidney and urinary tract (43.3%), followed by glomerular diseases (17.5%), hereditary kidney diseases (16.5%), metabolic diseases (7.2%) and other causes (15.5%). Mild CKD was found in 29.8%, moderate in 28.9%, advanced in 22.7%, and terminal in 18.6% children. Among patients with CKD stage 4 and 5, 75% of patients presented with acute renal failure, while 25% had earlier detected CKD (stage 1), but were not under regular follow-up. Associated complications included metabolic acidosis (63%), anaemia (60%), hypertension (42.3%), short stature (25.8%), renal osteodystrophy (13.4%) and cardiovascular diseases (7.2%). Conclusion. Congenital anomalies of the kidney and urinary tract are the leading cause of CKD in paediatric population. A significant proportion (41.3%) of patients had advanced and terminal CKD. In most patients CKD was diagnosed late and with associated complications.
Keywords	chronic kidney disease ; aetiology ; associated complications ; children ; Medicine ; R
Subject code	610 ; 616
Language	English
Publishing date	2012-01-01T00:00:00Z
Publisher	Serbian Medical Society
Document type	Article ; Online
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Article ; Online: Transient pseudohypoaldosteronism

Stajić Nataša / Putnik Jovana / Paripović Aleksandra / Bogdanović Radovan

Srpski Arhiv za Celokupno Lekarstvo, Vol 139, Iss 1-2, Pp 37-

2011 Volume 43

Abstract: Introduction. Infants with urinary tract malformations (UTM) presenting with urinary tract infection (UTI) are prone to develop transient type 1 pseudohypoaldosteronism (THPA1). Objective. Report on patient series with characteristics of THPA1, UTM and/ ... ...

Abstract	Introduction. Infants with urinary tract malformations (UTM) presenting with urinary tract infection (UTI) are prone to develop transient type 1 pseudohypoaldosteronism (THPA1). Objective. Report on patient series with characteristics of THPA1, UTM and/or UTI and suggestions for the diagnosis and therapy. Methods. Patients underwent blood and urine electrolyte and acid-base analysis, serum aldosterosterone levels and plasma rennin activity measuring; urinalysis, urinoculture and renal ultrasound were done and medical and/or surgical therapy was instituted. Results. Hyponatraemia (120.9±5.8 mmol/L), hyperkalaemia (6.9±0.9 mmol/L), metabolic acidosis (plasma bicarbonate, 11±1.4 mmol/L), and a rise in serum creatinine levels (145±101 μmol/L) were associated with inappropriately high urinary sodium (51.3±17.5 mmol/L) and low potassium (14.1±5.9 mmol/L) excretion. Elevated plasma aldosterone concentrations (170.4±100.5 ng/dL) and the very high levels of the plasma aldosterone to potassium ratio (25.2±15.6) together with diminished urinary K/Na values (0.31±0.19) indicated tubular resistance to aldosterone. After institution of appropriate medical and/or surgical therapy, serum electrolytes, creatinine, and acid-base balance were normalized. Imaging studies showed ureteropyelic or ureterovesical junction obstruction in 3 and 2 patients, respectively, posterior urethral valves in 3, and normal UT in 1 patient. According to our knowledge, this is the first report on THPA1 in the Serbian literature. Conclusion. Male infants with hyponatraemia, hyperkalaemia and metabolic acidosis have to have their urine examined and the renal ultrasound has to be done in order to avoid both, the underdiagnosis of THPA1 and the inappropriate medication.
Keywords	transient pseudohypoaldosteronism ; urinary tract infection ; urinary tract malformation ; Medicine ; R
Subject code	610
Language	English
Publishing date	2011-01-01T00:00:00Z
Publisher	Serbian Medical Society
Document type	Article ; Online
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Article ; Online: Effect of growth hormone replacement therapy in a boy with Dent's disease

Ludwig Michael / Pavicevic Snezana / Samardzic Mira / Bogdanovic Radovan

Journal of Medical Case Reports, Vol 5, Iss 1, p

a case report

2011 Volume 400

Abstract: Abstract Introduction Dent's disease is an X-linked recessive proximal tubulopathy characterized by low molecular weight proteinuria, hypercalciuria, nephrocalcinosis, nephrolithiasis and progressive renal failure. To the best of our knowledge, this is ... ...

Abstract	Abstract Introduction Dent's disease is an X-linked recessive proximal tubulopathy characterized by low molecular weight proteinuria, hypercalciuria, nephrocalcinosis, nephrolithiasis and progressive renal failure. To the best of our knowledge, this is only the third report on the use of growth hormone therapy in a child with poor growth associated with Dent's disease. Case presentation We report on a 7-year-old Montenegrin boy with proteinuria, hypercalciuria, nephrocalcinosis, rickets and short stature with unimpaired growth hormone secretion. A molecular genetic analysis showed S244L substitution on the CLCN5 gene. After two years of conventional treatment with hydrochlorothiazide, laboratory tests revealed more prominent proteinuria, mild hypophosphatemia, increased values of alkaline phosphatase and features of rickets. Phosphate salts, calcitriol, potassium citrate and growth hormone were included in the therapy. After three years of therapy, his adjusted parental stature was 1.53 standard deviations higher than at the initiation of growth hormone therapy. His global kidney functions and levels of proteinuria and calciuria remained relatively stable. In spite of the growth hormone therapy, his tubular reabsorption of phosphate deteriorated. Conclusion Treatment with recombinant human growth hormone may have a positive effect on final height in poorly growing children with Dent's disease and hypophosphatemic rickets. However, it is not possible to reach definite conclusions due to the small sample within the literature and the brief duration of the therapy.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2011-08-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
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Article: [Chronic kidney disease during a 12-year period at tertiary health institution].

Paripović, Aleksandra / Stajić, Nataša / Putnik, Jovana / Bogdanović, Radovan

Srpski arhiv za celokupno lekarstvo

2012 Volume 140, Issue 5-6, Page(s) 313–320

Abstract: Introduction: Chronic kidney disease (CKD) is a significant cause of morbidity and mortality in paediatric population.: Objective: The aim of the study was analysis of aetiology, staging and associated complications of CKD at the time of diagnosis.!## ...

Abstract	Introduction: Chronic kidney disease (CKD) is a significant cause of morbidity and mortality in paediatric population. Objective: The aim of the study was analysis of aetiology, staging and associated complications of CKD at the time of diagnosis. Methods: Data of 97 patients (56 boys) of average age 7.8 +/- 5.8 years, referred for the first time to the Institute for Mother and Child Healthcare "Dr Vukan Cupić", Belgrade in the period 1998-2009, due to CKD, stage 2-5, were analysed. In each patient illness history was obtained, and physical examination, laboratory, X-ray and other investigations were performed according to the indications. CKD was classified according to the glomerular filtration rate into four grades: 2--mild (60-90 ml/min/1.73 m2); 3--moderate (30-60 ml/min/1.73 m2); 4--advanced (15-30 ml/ min/1.73 m2); and 5--terminal (< 15 ml/min/1.73 m2). Results: The most frequent causes of CKD were congenital anomalies of the kidney and urinary tract (43.3%), followed by glomerular diseases (17.5%), hereditary kidney diseases (16.5%), metabolic diseases (7.2%) and other causes (15.5%). Mild CKD was found in 29.8%, moderate in 28.9%, advanced in 22.7%, and terminal in 18.6% children. Among patients with CKD stage 4 and 5, 75% of patients presented with acute renal failure, while 25% had earlier detected CKD (stage 1), but were not under regular follow-up. Associated complications included metabolic acidosis (63%), anaemia (60%), hypertension (42.3%), short stature (25.8%), renal osteodystrophy (13.4%) and cardiovascular diseases (7.2%). Conclusion: Congenital anomalies of the kidney and urinary tract are the leading cause of CKD in paediatric population. A significant proportion (41.3%) of patients had advanced and terminal CKD. In most patients CKD was diagnosed late and with associated complications.
MeSH term(s)	Adolescent ; Child ; Child, Preschool ; Female ; Glomerular Filtration Barrier ; Humans ; Male ; Renal Insufficiency, Chronic/etiology ; Renal Insufficiency, Chronic/physiopathology
Language	Serbian
Publishing date	2012-07-23
Publishing country	Serbia
Document type	English Abstract ; Journal Article
ZDB-ID	128567-1
ISSN	0370-8179 ; 0354-2793 ; 0049-0210
ISSN	0370-8179 ; 0354-2793 ; 0049-0210
DOI	10.2298/sarh1206313p
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Article ; Online: Congenital thrombocytopenia with nephritis

Kuzmanović Miloš / Kunishima Shinji / Putnik Jovana / Stajić Nataša / Paripović Aleksandra / Bogdanović Radovan

Vojnosanitetski Pregled, Vol 71, Iss 4, Pp 395-

The first case of MYH9 related disorder in Serbia

2014 Volume 398

Abstract: Introduction. The group of autosomal dominant disorders - Epstein syndrome, Sebastian syndrome, Fechthner syndrome and May-Hegglin anomaly - are characterised by thrombocytopenia with giant platelets, inclusion bodies in granulocytes and variable levels ... ...

Abstract	Introduction. The group of autosomal dominant disorders - Epstein syndrome, Sebastian syndrome, Fechthner syndrome and May-Hegglin anomaly - are characterised by thrombocytopenia with giant platelets, inclusion bodies in granulocytes and variable levels of deafness, disturbances of vision and renal function impairment. A common genetic background of these disorders are mutations in MYH9 gene, coding for the nonmuscle myosin heavy chain IIA. Differential diagnosis is important for the adequate treatment strategy. The aim of this case report was to present a patient with MYH9 disorder in Serbia. Case report. A 16-year-old boy was referred to our hospital with the diagnosis of resistant immune thrombocytopenia for splenectomy. Thrombocytopenia was incidentally discovered at the age of five. The treatment with corticosteroids on several occasions was unsuccessful. Although the platelet count was below 10 × 109/L, there were no bleeding symptoms. Besides thrombocytopenia with giant platelets, on admission the patient also suffered sensorineuronal hearing loss and proteinuria. The diagnosis was confirmed with immunofluorescence and genetic analyses. Conclusion. Early recognition of MYH9-related diseases is essential to avoid unnecessary and potentially harmful treatments for misdiagnosed immune thrombocytopenia, and also for timely and proper therapy in attempt to delay end-stage renal failure and improve quality of life. [Projekat Ministartsva nauke Republike Srbije, br. 175056 i br. 15079]
Keywords	thrombocytopenia ; nephritis hereditary ; myosin heavy chains ; diagnosis ; Serbia ; Medicine (General) ; R5-920
Subject code	616
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Military Health Department, Ministry of Defance, Serbia
Document type	Article ; Online
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