Renal functional reserve in transplanted and native single kidneys of children and adults.

Renal functional reserve (RFR) after an oral protein load was evaluated in 36 cyclosporine-treated children following kidney transplantation (Tx), in 15 kidney donors (Don), and in 15 children with single kidneys (Nx/Ag). Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were determined by clearances of inulin (and creatinine) and para-aminohippurate during water diuresis. Baseline and stimulated GFR and ERPF were determined and RFR was calculated as the difference between stimulated and baseline values. Baseline GFR and ERPF in Tx were lower than in Don and Nx/Ag. Both GFR and ERPF increased significantly in all groups from baseline to stimulated values. RFR GFR was 23% +/- 3%, 20% +/- 3% and 15% +/- 3% in Tx, Don, and Nx/Ag and RFR ERPF 35% +/- 4% in Tx, which was significantly higher than 20% +/- 4% and 15% +/- 3% in the two other groups respectively. Stimulated GFR and ERPF in Tx correlated with kidney length. No differences were seen in recipient-donor pairs, except for higher fractional increases of ERPF in recipients. There was no correlation between RFR measured by clearance of creatinine and clearance of inulin. In conclusion, cyclosporine-treated children following renal Tx were found to have a renal reserve capacity.

Food intake in patients with cystic fibrosis on an ordinary diet.

The food intake was analysed by means of a 3-day diary in 35 patients with cystic fibrosis, aged 1-65 years. All patients were prescribed an ordinary diet, and all had normal height and weight. The reliability of the method was checked in two patients, who kept diaries twice during a 6-month period. The results were almost identical. Most patients had a satisfactory intake of calories (mean (+/- SD) 97 +/- 23%). Only in five cases was the intake of calories per kg body weight less than that recommended. Protein constituted 11-22 kcal%, the mean protein intake being 178 +/- 55% of the recommended dietary allowance (RDA), most patients having much higher amount per kg body weight than that recommended. The mean fat content of the diet was 37 +/- 6 kcal% (range, 24-59). The calcium was in most cases much more than recommended owing to a high milk intake, the mean intake of calcium being 177 +/- 72% of RDA (range, 89-350). One additional patient had an extremely unbalanced diet, resulting in a caloric intake of more than 300% of RDA. This was due to supplementation with large amounts of special carbohydrate solutions (doctor's prescription), constituting 78 kcal%. Patients with cystic fibrosis on a free normal diet seem to have a satisfactory caloric intake compared with healthy individuals. The protein intake was too high, similar to what hsa been found in healthy Swedish children. The implication of this protein load in a disease with kidney and liver involvement has to be considered.(ABSTRACT TRUNCATED AT 250 WORDS)