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  • 1
    Electronic Resource
    Electronic Resource
    Manifestations of renal allograft rejection in small children receiving adult kidneys (1990)
    Springer
    Pediatric nephrology 4 (1990), S. 255-258 
    Details
    ISSN: 1432-198X
    Keywords: Rejection ; Hypertension ; Renal biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We were concerned that clinical manifestations of rejection (R) might be subtle in small children transplanted with adult kidneys. We retrospectively analyzed the first rejection episode (biopsy proven) in 22 children (R group) under age 4 years [mean age, 23.7±2.2 months (±SEM); mean weight, 9.4±0.4 kg] receiving an adult-related donor kidney. We matched these patients for age, date of transplant, donor source and immunosuppression with 36 children without R (control or C group). We compared both groups at similar intervals from transplantation, based on the time of R (5.38±1.2 months) in the R group and analyzed the immediate 8-week period prior to R and the corresponding interval in the C group. Hypertension occurred in 82% (18/22) of the R versus 8% (3/36) of the C group (P〈0.01). Fever longer than 7 days occurred in 45% (10/22) of the R versus 0% (0/36) of the C group (P〈0.01). Increased creatinine occurred in only 45% (10/22) of the R versus 3% (1/30) of the C group (P〈0.01). Cyclosporine did not influence these manifestations of R. The clinical manifestations did not predict the R grades on biopsy, which were moderate to severe in 13 and mild in 9 of the R patients. Graft survival was higher at 3 years in the C (95%) than in the R patients (65%), (P〈0.004). Thus, clinical manifestations of acute R can be subtle in small children with adult renal allografts. Renal biopsy should not be delayed until the creatinine is elevated in these patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00857670
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    The role of the pediatric nephrologist in the care of children with diabetes mellitus (1991)
    Springer
    Pediatric nephrology 5 (1991), S. 359-363 
    Details
    ISSN: 1432-198X
    Keywords: Diabetes mellitus ; Nephropathy ; Renal biopsy ; Urinary albumin excretion ; Blood pressure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The pediatric nephrologist has traditionally not been involved in the care of the diabetic child since diabetic nephropathy presents in adulthood. Recent studies suggest that diabetic kidney disease develops silently during childhood. Measurement of urinary albumin excretion (UAE) allows earlier detection of patients at risk of nephropathy, often in adolescence. In addition to diabetic nephropathy, diabetic children are at risk of urinary tract infections, renal papillary necrosis, and various forms of glomerulonephritis. The role of the pediatric nephrologist in the care of the child with diabetes might include advising on the administration and interpretation of screening for UAE and the measurement and interpretation of glomerular filtration rate, and blood pressure. Children with evidence of renal dysfunction should be evaluated and treated by the pediatric nephrologist. Frequently, renal biopsy will be necessary in these patients. Future research may allow the detection of diabetic kidney disease earlier in childhood, further expanding the role of the pediatric nephrologist. In particular, early renal biopsy may eventually be used to select those patients at risk of diabetic nephropathy for specific treatment alterations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00867504
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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