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The random urine albumin:creatinine (Ua:Uc) ratio was measured in 139 healthy children from newborn to age 4 years using the immunonephelometric method. This was shown to vary with age, the mean for neonates being 5.24mg/mmol (2SD range: 0.54-14.95mg/mmol) decreasing to 1.34mg/mmol (2SD range: 0.55-3.29mg/mmol) for the 2-4 years age range. The values for newborn to 6 months was significantly higher than the older age group (p less than 0.000001). 14 children with structural renal disease were then studied to determine the value of the random Ua:Uc ratio in detecting glomerular injury. This was found to be abnormal in children with glomerular filtration rate (GFR) less than 80ml/min/1.73m2 as well as in some children with complex bilateral renal structural abnormalities. Further longitudinal studies are required to determine the usefulness of this ratio in predicting progressive glomerular injury in this group of patients.

Munchausen syndrome by proxy is the falsification of symptoms by parents which results in their children having unnecessary and sometimes harmful hospital procedures. We describe a case of Munchausen syndrome by proxy in a 15 month-old toddler. The diagnosis, management and outcome of this syndrome is also discussed.

Chronic dialysis is a viable modality for treatment of end-stage renal disease in children, however, its limitation include negative effects on growth, progressive bone disease, and a poorer quality of life. Renal transplantation, on the other hand, allows the child a virtually normal life-style, with good prospects for employment and family life as an adult. Both patient and graft survival are significantly improved in children transplanted in centres with full paediatric facilities where special problems in young children are better addressed, such as that of fluid balance during the perioperative period, the age-related heightened immune responsiveness, and the different pharmacokinetic and pharmacodynamic handling of the various immunosuppressive agents in the child. Moreover, consideration of the problems of growth and developmental is crucial for maximal psychosocial rehabilitation of the paediatric transplant recipient.

In this paper, we describe a child with Henoch-Schonlein nephritis presenting with nephrotic syndrome and selective proteinuria. Renal biopsy showed ISKDC Class IIIA nephritis. He responded to steroid treatment and is currently well. The significance of renal involvement in Henoch-Schonlein Purpura is discussed.

It has been suggested that the negative charge on the surface of red blood cells (RBC) may reflect the charge on the glomerular capillaries. Measurements were made of RBC charge in patients with steroid-responsive nephrotic syndrome (SRNS) based on the binding of a cationic dye, alcian blue. There was no difference found between patients in relapse and in normal controls. We conclude that RBC charge measurements are not a reliable indicator of the glomerular charge barrier and a more specific method is required.

Rhabdomyolysis-induced acute renal failure is rare in a child. In this paper, we describe a young girl with this condition who unfortunately succumbed to adult respiratory distress syndrome. Renal biopsy confirmed the presence of tubular myoglobin casts and acute tubular necrosis but no cause for the rhabdomyolysis could be documented.

Complications of chemotherapy for a synovial sarcoma in an eight-year old boy included cisplatinum nephrotoxicity and adriamycin cardiotoxicity. The resultant renal failure and fluid overload necessitated peritoneal dialysis. Intractable hypomagnesemia was also a prominent feature.