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Behaviour of the filtration of red blood cells (rbc) passed through a filter paper was investigated. The rbc were incubated in fractions of blood plasma with different molecular mass (MM). By means of an Amicon membrane XM-50 the separation of plasma from healthy and uremic patients (children) was performed into two parts of different molecular sizes one of these was the concentrate (MM more than 50 000 = K) and the other was the ultrafiltrate (MM below 50 000 = UF). By a second step the UF was divided (Amicon membrane UM-50 into an UF1 (MM below 500) and into an UF2 (MM 500 to 50 000). In addition a hemofiltrate (MM below 5 000) was used for the incubation too. This hemofiltrate was made form pooled plasma of healthy and uremic patients, respectively. Rbc was incubated in both different fractions of plasma and hemofiltrate at a temperature of 37 degrees C and for a duration of 60 min. The pH-level and the osmolality were physiological. Under the influence of uremic UF the flexibility of rbc was clearly decreased. The UF1 had the most effect of the decrease of flexibility. Therefore the small substances which are easy dialysable play also an important role in the damage of rbc in the uremia.

The infantile stenosis of the vesical cervix is a rare disease, etiology and pathogenesis of which are controversial. If it is not treated it leads to uraemia. On the basis of a clinical material consisting of 8 patients clinic and course of the disease are discussed. In the children with stenosis of the vesical cervix observed by us disturbances of the miction (bilateral mictions, thin urinary stream), relapsing abdominal pain, enuresis, minor growth and haematuria were in the first place. We got clearness on the diagnosis by judging the mode of miction, by means of miction cystourethrography and by urethrocystoscopy. Even in stenosis of the vesical cervix with advanced renal insufficiency also in childhood an operation should be performed.

The blood pressure, urinary symptoms (proteinuria, hematuria, casts), the albumin- and cholesterol concentration in the serum and the renal function (GFR, RPF) of 125 children with chronic glomerulonephritis (GN) were analysed. 76 children had only single symptoms (93% proteinuria, 33% hypertension), which indicated a GN. The serum albumin and cholesterol concentration were pathological in 43% of the patients and serum creatinine level was pathological in 20% of the children. After 6 years the individual courses of renal function demonstrated a deterioration of GFR and RPF for most of the children. It can be concluded, that the summary consideration of epidemiology, symptomatology and renal function of different glomerular lesions has only a limited application to the clinical practice.

From 101 children with histological verified glomerulonephritis the following data were analyzed according to the morphological alterations: age distribution, symptoms and onset of the disease, previous diseases, and observation time. Differences of these parameters were found firstly between minimal glomerular changes and proliferative lesions. Within the various proliferative forms the differences were minimal. In children with a diffuse mesangio-proliferative glomerulonephritis and MPGN the characteristics of blood pressure, proteinuria and hematuria were observed during a follow-up time of 5 years. In conclusion, a distinction between single types of glomerulonephritis could be made exceptionally without examination of kidney function and morphology.

For characterising the elimination and metabolisation performance of the liver in chronic renal insufficiency the galactose load test was carried out. 9 children with healthy liver and kidneys, 35 children with chronic renal insufficiency (15 were conservatively treated = group 1, 20 were in the chronic haemodialysis programme = group 2) as well as 5 children after kidney transplantation were examined. In group 1 a normal blood galactose concentration was present. Patients of the 2nd group showed increased concentrations of galactose in the blood which might refer to a decreased redox potential in the liver caused by the uraemic intoxication. In the group of patients who underwent a kidney transplantation in the patients with azathioprine therapy a disturbed use of galactose was present. Children with cyclosporin-A had a normal galactose concentration.

Under the influence of the uraemic plasma a number of changes of the metabolism of red blood cells develop. By means of cross experiments with the help of filtrability, of sulf-haemoglobin formation and the 125-iodine-hippuran intake the influence of the uraemic plasma and of the plasma of healthy persons on the red blood cells of children who undergo a chronic haemodialysis as well as of healthy adults (cross experiments) was examined. The red blood cells of the control persons after an incubation at 37 degrees and 60 or 180 minutes showed approximately the same changes of filtrability, formation of sulf-haemoglobin and 125-iodine-hippuran as the red blood cells of the patients with incubation in the autologous plasma. Disturbances of the filtrability and the formation of sulf-haemoglobin could be proved in the uraemic red blood cells still after reincubation in the normal plasma, though clearly reduced. Only in 125-iodine-hippuran a normalisation could be got. Filtrability and formation of sulf-haemoglobin apparently comprise more complex processes which essentially influence the life span of the red blood cells, whereas the 125-iodine-hippuran value characterizes only a part of the metabolism of the red blood cells, the passive transport of anions.

400 children (141 boys and 259 girls) in a renal disease care system were analyzed regarding their most frequent diagnoses of renal diseases and their age and sex distribution. Furthermore, the familiary situation, the time of observation, the number of consultations and the frequency of morphological changes of the kidney and the urinary tract were examined. 72% of the children suffered from urinary tract infection and in 10% a glomerulopathy and in 5.5% an urolithiasis were found. The symptoms of enuresis occurred in 22.2% of the patients. Infants were the most frequent age group (18%), 70% of which were boys. We found no differences in the incidence of renal diseases in comparison with other reports.