[Practical comments on the diagnosis of so-called functional proteinuria and suggestions for a diagnostic algorithm]. / Praktické poznámky k diagnostike tzv. funkcných proteinúrií a návrh algoritmu diagnostiky.

The submitted paper, based on the authors' experience, summarizes basic findings pertaining to isolated proteinuria. In addition to a simple classification the authors outline in a diagram the differential diagnostic procedure in patients with isolated proteinuria.

A new approach in radionuclide imaging to ureteric peristalsis using 99Tcm-MAG 3 and condensed images.

A new method for the evaluation of ureteric peristalsis is described. Standard, dynamic renal scintigraphy was carried out using 99Tcm-MAG 3 in 59 patients. Time-activity curves and condensed images over the ureter area were created simultaneously. A six-grade scale (O-V) was chosen for the classification of ureteral function. The results obtained were compared with parameters of renographic curves and other clinical findings. In a group of 13 patients, two different renal radiopharmaceuticals were used: 131I-OIH and 99Tcm-DTPA. The results show that the new method is suitable for the assessment of ureteral disorders, and has some advantages compared with previously described methods. 99Tcm-MAG 3, with a better target-to-background ratio compared to 131I-OIH and 99Tcm-DTPA, is the most suitable radiopharmaceutical for this purpose.

[The effect of prednisone in the development of nephropathy in Schoenlein-Henoch purpura]. / Ovplyvnenie vzniku nefropatie pri Schönleinovej-Henochovej purpure prednisonom.

The authors hospitalized in 1976-1987 39 children with Schönlein-Henoch's purpura who on admission had a normal finding in urine. Of the above patients 28 were given prednisone already at the onset of hospitalization, to 11 prednisone was not administered. Patients with prednisone developed nephropathy in one instance (3.5%), patients without prednisone 6 times (54.5%) which is a significant difference. The average prednisone dose was 1.7 mg per kg body weight per day for an average period of 21 days. Usually for 6-10 days the same dose was administered and then it was gradually reduced.

Contribution to the aetiopathogenesis of orthostatic proteinuria in children: relation to the upper calyx syndrome.

The authors discuss the correlations between the upper calyx syndrome and proteinuria. The syndrome was demonstrated in 33.6 per cent of all children with orthostatic proteinuria hospitalized at the Paediatric Clinic, Martin (Czechoslovakia) during 1978-1985. They consider the possible relations between these conditions that could be mediated by the activation of the renin/angiotensin II system. The direct stimulus of this system could rest in local ischaemization of parenchyma in the region of the proximal pole of the kidney or its partial passive congestion. They assume that these changes become more marked in the standing position and may cause proteinuria of orthostatic character. The inhibition of the renin/angiotensin II system may obviously lead to decreased proteinuria.

Incidence of renal complications in Schönlein-Henoch purpura syndrome in dependence of an early administration of steroids.

Between 1976 and 1986, the authors treated 33 children with Schönlein-Henoch purpura (S-H purpura), with physiological urinary finding on admission. Twenty-three of them received prednisone already at the beginning of hospitalization, 10 were not given any prednisone at all. In patients with prednisone, nephropathy occurred only once (4.3%), in those without prednisone it occurred 5 times (50%), the incidence being thus significantly higher. Prednisone was administered in doses ranging between 1.0 and 2.5 mg/kg body mass/day, on an average for 21 days (first 10 days in the same dose, later in reduced doses). Since there is a general lack of data on the positive effect of steroids upon the prevention of nephropathies in S-H purpura, the authors recommend more thorough studies in the initial stage of the disease (before the development of nephropathies).

X-ray changes in the kidneys of children with orthostatic proteinuria.

In 38 patients with orthostatic proteinuria (O.P.) and in 31 children of the control group (C) roentgenograms of excretory urography have been compared, made in the standing erect and in the lying down posture. In children with O.P. significantly more frequent and more expressive ptosis of the kidneys during orthostasis was found than in the controls. In children with O.P. disturbed urine outflow was found in 36.8%, while in children of the control group only in 3.2%. On the basis of the results obtained relations between haemodynamic changes in ptosis of the kidneys, disturbed urine outflow and the origin of O.P. are analysed.