Search

Presents information on an extended study of children with nephrotic syndrome. Prognosis related to clinical features; Initial response to corticosteroid therapy.

Acute renal failure is a complicated disturbance, which taxes the clinical skills of (he physician. This paper reviews the metabolic derangements, the principles of treatment, the consequences, and the advances recently made in our understanding of the pathophysiology and management of acute renal failure. [ABSTRACT FROM AUTHOR]

Presents the text of an address given by C.M. Edelmann, Jr., the recipient of the E. Mead Johnson Award for 1972 in South Bronx, New York City, which deals with pediatric nephrology.

Giant hydronephrosis in children, and particularly in infants, is frequently responsible for abdominal masses. High close intravenous urography has proved very useful in studying the degree of pyelocalyceal dilatation, as well as the amount of residual renal parenchyma and the possible recovery of these kidneys. Reparative surgery, rather than primary nephrectomy, should always be considered. Renal transplantation may save those with giant bilateral hydronephrosis who appear now to he beyond the possibility of surgical repair. [ABSTRACT FROM AUTHOR]

Presents information on a study which examined the chronic hemodialysis of a child. Methodology; Results; Discussion.

The continued success of hemodialysis and later kidney transplantation when feasible have made these the accepted and recognized modes of therapy for children with terminal renal disease. As survival rates improve, dietary therapy is most important in bringing the patients to transplant in the best possible condition. The present paper not only reviews the known nutritional principles in the control of renal failure, hut also offers practical guidelines and diets for good management of uremic infants and children. [ABSTRACT FROM AUTHOR]

Discusses the procedures for peritoneal dialysis for the treatment of renal failure and poisoning situations in children. Safety and efficacy of the procedure; Complications of the procedure citing the occurrence of abdominal pain, hypocalcemia and overhydration; Indications for pediatrics.

This article presents a discussion among health professionals that examines the relationship of kidney disease to hypertension in childhood. The patient for discussion is a six and one-half-year-old white girl from Nashua, New Hampshire. She is in good health until about one month prior to admission in a hospital. The pattern describes by the parents is that she would get up in the morning, vomit several times, feel better, go to school, and play normally the rest of the day. However, thirteen days prior to admission, the girl is seen by her family physician who noted that she is severely dehydrated and has a blood pressure of 180 over 110 mm.

This article examines cases of sudden death in the nephrotic syndrome. Sudden death unrelated to renal failure during the course of the nephrotic syndrome is not unknown. There has been a report that two patients died during adrenocortical steroid therapy, after developing hypertension and hyponatremia. Other similar cases are also reported to be successfully treated with infusions containing sodium chloride or with serum albumin. In this article, three children with the nephrotic syndrome in whom salt depletion could have been important in leading to unexpected death, is described. Awareness of this possibility and attention to the sodium metabolism of children with the nephrotic syndrome may prevent similar deaths in the future.

Reports on the treatment of the uncomplicated nephrotic syndrome in children with triamcinolone. Characterization of the disease by the presence of edema, hypoproteinemia, hyperlipemia and proteinuria; Efficacy of antibiotics in eliminating almost completely the secondary serious infections; Examination on the side reactions of cortisone and ACTH.

The following classical description was given by Blackfan 14 in 1924; ‘It is rarely seen in infancy or early childhood, but is found with increasing frequency until after puberty, after which time it diminishes rapidly and becomes infrequent in adult life. The children who have this condition are usually tall and slender. It is much more marked if the patient assumes the lordotic position. The prognosis is excellent. Some cases have been reported in which the albuminuria persisted throughout adult life but in a majority it disappears during adolescence.’ Thus it appears from the literature that the incidence of proteinuria in children may be 15 to 30 per cent or more. The maximum reported in a controlled series was 46.5 per cent. It is entirely possible that one-fourth and perhaps even one-third of all individuals may have orthostatic proteinuria sometime during adolescence, and especially those who are tall and thin. The condition seems to reach a peak at about the age of 15 or 16 years and declines rapidly after that. It occurs in only about 5 per cent of 17 and 18 year old youths and drops to about 2 per cent during the third decade. From 90 to 95 per cent of the proteinuria in children is orthostatic in type. It is more common in summer than in winter. With the exception of one author (who studied primarily adults) all follow up studies of this condition which we have reviewed have indicated a good prognosis, and in some series the follow up has been for 25 or more years. The incidence of subsequent renal disease has been very low. Most subjects have remained in good health. The high incidence in older children and adolescents, with a much lower incidence in adults, indicates that this proteinuria clears before adult life. As stated by R. J. Slator 49 of the University of Toronto; ‘There seems no doubt there exists a phenomenon of benign postural proteinuria unassociated with renal disease, a physiologic variant of normal.’ [ABSTRACT FROM AUTHOR]

Deals with a study which examined treatment for a child suffering from methylmalonic aciduria. Case report; Methods; Results; Discussion; Summary.

Discusses the mechanism by which infective bacteria may block the therapeutic effect of steroids in childhood nephrosis. Claim that some bacteria apparently possess enzyme systems which can act upon and alter the steroid molecule; Effect of doubling the dose of triamcinolone on the nephritic disturbance; Implications for other diseases such as asthma and bacterial sepsis.