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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric radiology 9 (1980), S. 153-160 
    ISSN: 1432-1998
    Keywords: Kidney size ; Renal parenchymal thickness ; Small kidney ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Kidney length (KL), renal area and renal parenchymal area were measured on i. v. urograms of 255 children without apparent kidney disease age 0 to 14 years. These parameters were compared with age, body height, body surface area and the distance between the 1st and 4th lumbar vertebral body. In addition, renal parenchymal thickness was determined at the upper and lower poles. Mean values for normal KL were significantly greater on the left side than on the right side requiring separate growth charts. A mean increase in KL of 6.3 mm for the left and 6.0 mm for the right kidney was calculated for a change of 10 cm body height. A small kidney is defined by a KL below-2 Sd for the corresponding body height and/or a quotient of right KL/left KL outside ±2 SD from the mean value. Localised loss of renal parenchyma is reflected by an increased or decreased quotient of the upper to the lower polar thickness and reduction of total kidney mass by a diminished bipolar parenchymal thickness related to body height.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1998
    Keywords: Xanthogranulomatous pyelonephritis ; Tumor ; Nonfunctioning kidney ; Foam cells ; Angiography ; Ultrasonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Xanthogranulomatous pyelonephritis (XPN) is a rare, unilateral manifestation of chronic pyelonephritis. It is characterized by extensive damage to the parenchyma and its replacement by xanthogranulomatous tissue. The main roentgenological feature is a functionless kidney, often with calcfication. The clinical, pathological and roentgenological findings of our three patients are analyzed and compared with previously reported findings, most notably those in childhood. A tentative diagnosis of XPN can be made from intravenous urography and echography of the kidney. In general, angiography does not provide additional pathognomonic features. The final diagnosis of XPN can only be made by histological microscopic examination. The prognosis of this disease is considered to be good, when the affected kidney is removed and function on the contralateral side is good.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric radiology 5 (1976), S. 86-92 
    ISSN: 1432-1998
    Keywords: Segmental renal hypoplasia ; Congenital small kidney ; Hypertension ; Child ; Radiology ; Differential diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Radiological findings of segmental renal hypoplasia are reported, based on the observation of 6 children aged between 8 and 14. The leading clinical symptom is arterial hypertension. Urinary tract infection and proteinuria are additional common findings. Cases with bilateral disease often have renal failure. The intravenous urogram shows unilateral or bilateral small kidneys with segmental renal scarring and transverse lobulation. In the pathological areas the calyces are ectatic or clubbed and their infundibulum is elongated. Vesico-ureteral reflux is frequent. In angiography the lobulated segments appear hypovascular. Diagnosis was verified by histological examination.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 60 (1982), S. 1115-1125 
    ISSN: 1432-1440
    Keywords: Long-term management ; Inherited renal tubular disorders ; Fanconi syndrome ; Pharmacotherapy ; Langzeitbetreuung ; Tubulopathien ; Fanconi-Syndrom ; Pharmakotherapie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Hereditäre Tubulopathien mit isolierten tubulären Funktionsstörungen erfordern oft keine oder nur eine einfache, aber wirksame ärztliche Behandlung. Bei einigen angeborenen Stoffwechselerkrankungen mit komplexen tubulären Störungen gibt es eine spezifische Form der Behandlung, wie z.B. die galaktosefreie Diät bei der Galaktosämie oder die Entleerung der Kupferspeicher bei der Wilson'schen Erkrankung. Bei Patienten mit idiopathischem Fanconi-Syndrom, Zystinose, oculo-cerebro-renalem Syndrom oder Glykogenose Fanconi-Bickel hat die symptomatische Substitutionsbehandlung mit Flüssigkeit, Elektrolyten und Wasser die Lebenserwartung in den letzten 20 Jahren deutlich erhöht. Die Substitutionsbehandlung scheint jedoch keinen Einfluß auf die Entwicklung einer chronischen Niereninsuffizienz zu haben. Die Langzeitbetreuung von Patienten mit angeborenen Tubulopathien sollte sowohl die Behandlung der Tubulopathie, der chronischen Niereninsuffizienz und der mitbetroffenen Organe als auch die genetische Beratung und Hilfestellungen bei der sozialen Eingliederung beinhalten.
    Notes: Summary In inherited renal tubular disorders with isolated defects of tubular transport medical treatment is usually either not indicated or is simple and effective. In some inherited metabolic disorders with complex defects of renal tubular transport a specific therapy is known. For example, in galactosemia and hereditary fructose intolerance crude products may be restricted or in cases of Wilson's disease copper stores may be reduced. In idiopathic Fanconi syndrome, cystinosis, oculocerebrorenal syndrome and glycogenosis Fanconi-Bickel, a symptomatic replacement treatment based on supplementation of water, electrolytes and vitamin D has improved the non-uremic survival of these patients considerably within the last 20 years. For long-term management of inherited renal tubular disorders, treatment of tubular dysfunction, chronic renal failure, and involved extrarenal organs must be supported by genetic counseling and assistance for social integration.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-2277
    Keywords: Pediatric renal transplantation ; Cyclosporin, low-dose, in children ; Growth, cyclosporin, in kidney transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fifty-one pediatric patients undergoing a first cadaveric kidney transplantation were followed for at least 2 years after grafting. They were divided into two groups: those treated with methylprednisolone plus azathioprine (AZA) and those treated with methylprednisolone plus low-dose cyclosporin A (CyA; median dose 109 mg/m2 per day ≙ 3.4 mg/kg per day after 1 year). The steroid dosage given was significantly lower in the second group. The 4-year graft survival rate was 68% for the AZA group and 78% for the CyA group. Renal function did not differ significantly in the two groups; after 1, 2, and 3 years, the median 24-h creatinine clearance was 79, 69, and 51 ml/min/1.73 m2, respectively, for the AZA group and 78, 63, and 68 ml/min/1.73 m2, respectively, for the CyA group. Linear growth was similar in the two groups. We conclude that in pediatric patients the results of low-dose CyA immunosuppression do not differ significantly from those obtained with AZA in terms of graft survival, renal function, or growth.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 394 (1982), S. 235-254 
    ISSN: 1432-2307
    Keywords: Nephronophthisis ; Chronic sclerosing tubulo-interstitial nephropathy ; Associated defect
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The clinical and morphological findings are described in 27 children with nephronophthisis. Seventeen children were considered as sporadic cases. In 10 familial cases the presumed mode of inheritance was autosomal recessive. The clinical picture was rather uniform: polyuria-polydipsia, hyposthenuria, anemia, growth retardation, and azotemia with progressive renal failure. Six patients presented with tapeto-retinal degeneration. In a further seven children other ocular changes were detected. Two female siblings showed additional non-renal manifestations: mental retardation, pulmonary emphysema, skeletal anomalies, and congenital hepatic fibrosis. Renal histology displayed a chronic sclerosing tubulo-interstitial nephropathy with extensive tubular atrophy and dedifferentiation. Medullary cysts were frequently found in end-stage kidneys. Immunofluorescence was either non-specific or completely negative. On electron microscopy, the tubular basement membrane changes predominated: thickening, lamellation, splitting, and deposition of microfibrils within the increased basement membrane substance. Detailed light- and electron microscopic findings were non-specific but the overall morphologic picture was characteristic and even diagnostic in conjunction with the clinical presentation. A recurrence of nephronophthisis in transplanted kidneys has not been observed. The pathogenesis of nephronophthisis is obscure but with respect to the morphologic findings a primary or secondary tubular basement membrane defect seems very likely. Our experience suggests that nephronophthisis is a frequent cause of chronic renal failure in children and commonly associated with non-renal abnormalities. To avoid the separation of different syndromes presenting with a uniform renal disease but various non-renal manifestations, we suggest that the term “nephronopthisis complex” be used.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 397 (1982), S. 193-202 
    ISSN: 1432-2307
    Keywords: Minimal change nephrotic syndrome ; Children ; Morphometry ; Mesangial hypercellularity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Renal biopsies from 25 children with steroid-sensitive minimal change nephrotic syndrome were evaluated retrospectively to determine whether there is any relation between the morphological changes and the frequency of relapses. Biopsy material was examined by light-, immunofluorescence-, and electron microscopy, and by morphometric methods. The patients were divided in a group of 15 children with frequent relapses (FR) and another group of 10 children with an absence of, or only infrequent, relapses (NR/IR). Semiquantitative evaluation of biopsy specimens disclosed no significant differences between groups, but morphometric measurements performed on toluidine stained semithin sections showed a significant increase of mesangial nuclei in FR compared with NR/IR (P〈0.01). Furthermore, the mean area of mesangial nuclei was decreased and the relative frequency of smaller nuclear profiles was higher in patients with FR compared to NR/IR (p〈0.01). These findings suggest mesangial cell activation in FR which may be related to a longer course of the disease prior to renal biopsy (mean 4.0 years in FR vs. 1.4 years in NR/IR). In our opinion, morphometric assessment of discrete mesangial alterations is a promising method for exploring clinicopathological correlations in minimal change nephrotic syndrome.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric nephrology 3 (1989), S. 397-400 
    ISSN: 1432-198X
    Keywords: Aldosterone ; Atrial natriuretic peptide ; Chronic renal failure ; Dopamine ; Noradrenaline ; Sodium homeostasis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In order to evaluate the possible role of vasoactive hormones in the mechanism of exaggerated sodium loss due to reduced renal mass we measured plasma concentration of atrial natriuretic peptide (ANP), aldosterone, plasma renin activity (PRA), plasma noradrenaline, and dopamine, in 12 children with advanced chronic renal failure (mean CIn17.8-2.6,x± SEM, CPAH93.5±17 ml/min per 1.73 m2, FENa7.0±0.95%). No patient had clinical signs of volume overload. Plasma concentrations of ANP were not significantly different from those of healthy agematched controls (29.2±7.2 vs 23.2±3.1 fmol/ml) and did not correlate with urinary sodium excretion. Plasma concentrations of aldosterone, PRA and noradrenaline, were also within the physiological range, while plasma dopamine levels were elevated (260±36 vs 98±11 pg/ml, 〈0.001). Our data do not support the notion that ANP or the renin-aldosterone axis play a major role in the adaptation of remaining nephrons to maintain long-term sodium balance in normotensive children with chronic renal failure.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric nephrology 1 (1987), S. 428-435 
    ISSN: 1432-198X
    Keywords: Glomerular basement membrane ; Type IV collagen ; Alport's syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Urinary excretion of glomerular basement membrane (GBM)-related peptides was analysed in 72 patients with a variety of renal diseases by immunoblotting using polyclonal antibodies against either collagenase or pepsin digests of human GBM. The specificity of the antibodies was verified by elution of antibodies bound to urinary GBM-related peptides on nitrocellulose blots and demonstration of reactivity of the eluted antibodies with the respective GBM digests. Furthermore, six mice immunized with urinary GBM-related peptides all developed focal linear deposits of mouse IgG along their GBM, linear and mesangial deposits of C3 in the glomeruli and serum antibodies reactive with human GBM. Monoclonal antibodies against urinary GBM-related peptides of one of the mice reacted with different peptides of the non-collagenous and collagenous domains of type IV collagen, the major structural protein of GBM. In the majority of the 75 patients' urines tested, excretion of GBM-related peptides with molecular weights of 33, 50, 80 and 150 kilodaltons (kD) was detectable. Patients with a diminished glomerular filtration rate (GFR) demonstrated excretion of the 33 kD peptide more frequently (91%) and never of the 80 kD peptide as compared with patients with normal GFR (33 kD [42%] 80 kD [87%]). The pattern of urinary GBM-related peptides was not specific for the underlying renal disease as in Alport's syndrome.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 141 (1983), S. 63-65 
    ISSN: 1432-1076
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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