The relationship between calcium, phosphorus, and sodium intake, race, and blood pressure in children with renal insufficiency: a report of the Growth Failure in Children with Renal Diseases (GFRD) Study.

Nutritional data compiled during the Growth Failure in Children with Renal Diseases Clinical Trial were analyzed to determine the relationship between the dietary intake of divalent minerals and sodium, nutritional status, and serum calcium, phosphorus, and parathyroid hormone (PTH) concentrations and blood pressure in black versus white children. One hundred eighteen patients are included in this report; 25 were black (21%) and 93 were white (79%). Although more of the blacks were male, the age distribution, midarm circumference, midarm muscle circumference, blood pressure, and serum calcium, phosphorus, and PTH concentrations were comparable in the two groups. Phosphorus intake was within the recommended daily allowance in both groups; in contrast, calcium intake was inadequate in all patients: 81% of the recommended daily allowance in whites, and 74% in blacks. Sixteen children were noted to be hypertensive during the observation period; six patients were receiving a variety of antihypertensive medications, including diuretics in two children. Linear regression analysis revealed that systolic and diastolic blood pressures were directly related to calcium and phosphorus intake in black patients. In white children, only dietary phosphorus intake and diastolic blood pressure were directly related. There was no relationship between sodium intake or GFR and blood pressure in the white or black children. PTH levels were directly correlated with systolic and diastolic blood pressure in all children. The correlations between PTH and blood pressure were stronger in white versus black patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Localization of platelet antigens in human kidney disease.

The localization of a platelet antigen or antigens kidneys from 106 patients with renal disease was evaluated with immunofluorescent microscopy by using a rabbit antibody to human platelets. The antiplatelet IgG fixed to the surface membrane of platelets did not react with erythrocytes, leukocytes, plasma, normal kidney, or a variety of normal tissue targets. Significant glomerular and vascular deposition of platelet antigen (or antigens) was observed along the endothelium or as vascular plugs in kidney tissue from patients with hemolytic uremic syndrome, membranoproliferative glomerulonephritis (types I and II), diabetic nephropathy, hypertensive renal disease, scleroderma, and other diseases. Dual-label immunofluorescent studies revealed that platelet antigen (or antigens) and fibrinogen/fibrin-related antigen (FRA) were usually, though not always, present in similar loci. Platelet antigens were not observed at sites of intense FRA deposition: in the mesangium in anaphylactoid purpura and in glomerular crescents in Goodpasture's syndrome. Platelet antigen was detected in the peritubular capillaries of most patients with diabetic nephropathy.

Inherited deficiency of the second component of complement (C2) with membranoproliferative glomerulonephritis.

The occurrence of membranoproliferative glomerulonephritis in a 13 year old boy with inherited complete deficiency of the second component of complement (C2) is described here for the first time. Results of the complement studies and the associations of glomerulonephritis with complement deficiencies are discussed.