Averting the legacy of kidney disease - focus on childhood

World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD) in childhood differs from that in adults, in that the largest diagnostic group among children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease as a consequence of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertension and CKD in later childhood or in adult life. Children born early or who are small-for-date newborns have relatively increased risk for the development of CKD later in life. Persons with a high-risk birth and early childhood history should be watched closely in order to help detect early signs of kidney disease in time to provide effective prevention or treatment. Successful therapy is feasible for advanced CKD in childhood; there is evidence that children fare better than adults, if they receive kidney replacement therapy including dialysis and transplantation, although only a minority of children may require this ultimate intervention. Because there are disparities in access to care, effort is needed so that children with kidney disease, wherever they live, may be treated effectively, irrespective of their geographic or economic circumstances. Our hope is that the World Kidney Day will inform the general public, policy makers and caregivers about the needs and possibilities surrounding kidney disease in childhood.

Testing methods for detection of Cryptosporidium spp in water samples.

A large waterborne outbreak of cryptosporidiosis in Milwaukee, Wisconsin, USA in 1993 prompted a search for ways to prevent large-scale waterborne outbreaks of protozoan parasitoses. Methods for detecting Cryptosporidium parvum play an integral role in strategies that lead to appropriate treatment of surface water, but are criticized because they produce results that are highly variable. The US Environmental Protection Agency developed a set of criteria to evaluate detection methods for protozoan parasites in water. As a consequence, the Agency has had to develop approaches to reducing uncertainty of evaluations. The variability and accuracy of various methods of producing small numbers of Cryptosporidium spp oocysts were tested. The least variable and most accurate method was used to spike seven surface water, and one tap water sample to compare 4 detection methods that had been reported in the literature. The least variable and most accurate method for spiking specified numbers of oocysts into samples was found to be flow cytometry. The most effective of the methods tested for detection in surface, tap and reagent water was solid phase cytometry.