Subject(s)
Complement System Proteins/deficiency , Infections/etiology , Urticaria/complications , Vasculitis/complications , Child, Preschool , Collagen Diseases/classification , Disease Susceptibility , Humans , Kidney Diseases/etiology , Kidney Diseases/pathology , Male , Skin/pathology , SyndromeSubject(s)
Catheters, Indwelling , Kidney Failure, Chronic/therapy , Peritoneal Dialysis, Continuous Ambulatory/instrumentation , Peritoneal Dialysis/instrumentation , Adolescent , Child , Child, Preschool , Evaluation Studies as Topic , Female , Humans , Male , Peritoneal Dialysis/adverse effects , Peritoneal Dialysis, Continuous Ambulatory/adverse effects , Peritonitis/etiologySubject(s)
Adolescent , Adult , Middle Aged , Humans , Male , Female , Chronic Kidney Disease-Mineral and Bone Disorder , Calcium , Phosphorus , Renal Insufficiency, ChronicABSTRACT
Se informa el caso de un paciente masculino de 14 anos de edad en el cual se encontro hipocalemia, perdida renal de potasio, alcalosis metabolica, hipertension arterial, actividad de renina plasmatica normal y aldosterona disminuida, con lo que se descarto hiperaldosteronismo primario y sindrome de Bartter y se llego al diagnostico de sindrome de Liddle. Este es un padecimiento hereditario que se transmite con caracter autosomico dominante, en el cual existe un aumento de la reabsorcion de sodio y de la secrecion de potasio por las celulas de tubulo distal del nefron, independiente de aldosterona, asi como una alteracion del transporte de sodio en los eritrocitos. El paciente recibio tratamiento con cloruro de potasio y con amiloride a dosis de 5 mg. diarios con lo cual se logro normalizacion del potasio serico, correccion de la alcalosis, diminucion de la excrecion urinaria de potasio y control satisfactorio de la hipertension arterial
Subject(s)
Adolescent , Humans , Male , Kidney Diseases , Potassium , SodiumSubject(s)
Kidney Transplantation , Adolescent , Adult , Child , Evaluation Studies as Topic , Histocompatibility , Humans , Immunosuppression Therapy , Kidney Failure, Chronic/epidemiology , Kidney Failure, Chronic/rehabilitation , Kidney Failure, Chronic/therapy , Major Histocompatibility Complex , Middle Aged , Postoperative Complications , Spain , Tissue Donors , Transplantation ImmunologyABSTRACT
En general se reconocen dos mecanismos principales de produccion de proteinuria: incremento de la permeabilidad glomerular y reduccion de la resorcion tubular renal.Sin embargo, existe un tercer mecanismo que consiste en paso aumentado de proteinas por el filtro glomerular normal, a consecuencia de incremento en su concentracion serica. A este ultimo respecto se describe el caso de un nino con enfermedad de Christmas que desarrollo proteinuria masiva secundaria a hiperproteinemia inducida por transfusiones multiples de plasma. La proteinuria desaparecio al suspenderse estas transfusiones
Subject(s)
Child, Preschool , Humans , Male , Proteinuria , Hemostasis , Blood Proteins , Blood TransfusionABSTRACT
El transplante renal es una modalidad terapeutica efectiva para los ninos con estadio final de la enfermedad renal. No hay contraindicaciones absolutas para ofrecer el procedimiento a estos ninos y sus familias; sin embargo los enfermos con retraso mental profundo u otro factor de alto riesgo deben ser considerados de acuerdo a las necesidades y criterios de cada programa. El mayor obstaculo lo constituye el fenomeno de rechazo inmunologico que sera de menor magnitud y racional inmunosupresion. El crecimiento estatural en ninos transplantados es suboptimo. Varios factores han sido implicados; entre los mas importantes, senalamos el efecto indeseable de los corticosteroides. No obstante la necesidad de adquirir mayor experiencia en el terreno de la inmunologia del transplante y el escepticismo que sostienen algunos grupos, pensamos que el transplante renal es el mejor metodo de rehabilitacion para los ninos con enfermedad renal terminal. Transplante renal, insuficiencia renal cronica
Subject(s)
Humans , Histocompatibility , Kidney , Renal Insufficiency, Chronic , Transplantation , Transplantation ImmunologySubject(s)
Child, Preschool , Child , Adolescent , Humans , Male , Female , Renal Dialysis , Kidney DiseasesABSTRACT
Five uremic (7.0 - 15.2 years), non-dialyzed children treated medically (group 1) had an intravenous glucose tolerance test (0.5 g/kg). Blood samples were obtained at frequent intervals and duplicate determinations of plasma glucose (glucose-oxidase method on Somogyi-Nelson protein-free filtrates), insulin and free fatty acids were performed. The same study was performed in eleven children (12.3 - 18.0 years) with chronic renal failure undergoing long-term hemodialysis (group 2), before and two hours after dialysis. Results were compared to a group (group 3) of eight healthy children (7.5 -- 17.5 years). In group 1 a "normal" insulin response was observed in the presence of hyperglycemia and the plasma glucose clearance was in the diabetic range. Twice weekly hemodialysis produced no beneficial acute effects on group 2, based on absolute glucose values or plasma glucose clearance rates, on groups as well as on individual basis; however, a clear hyperinsulinemia was present which was of even higher magnitude three and six months after the initial study. These results demonstrated that chronic hemodialysis had no beneficial acute effects on plasma glucose concentration or plasma glucose clearance rate. However, it may have obvious long term beneficial effects on glucose tolerance by enhancing pancreatic insulin release (to overcome peripheral insulin resistance) to such an extent as to maintain a normal carbohydrate tolerance.
Subject(s)
Kidney Failure, Chronic/therapy , Adolescent , Child , Female , Glucose Tolerance Test , Humans , Insulin/metabolism , Insulin Secretion , Kidney Failure, Chronic/blood , Male , Renal Dialysis , Secretory RateABSTRACT
Seventy-eight A-V fistulas were constructed in 45 children whoses age were between 4 to 16 years, in order to use it for chronic hemodialysis. Twenty-four of them were external A-V shunts which were occluded by thrombosis in 13 instances and deinserted in 3 patients. Thirty-six A-V fistulas were performed with saphenous wein autograft between an artery and vein at the forearm. The main complication in this group was thormbosis in 10 instances and dilations of the graft in 5. In 9 patients, latero-lateral arteriovenous anasthomosis was performed. In these, adequate blood flow developed slowly or was poor in most patients. Six patients with saphenous-femoral anasthomosis developed thrombosis in 3 instances and venous puncture was frequently difficult. In three other patients, bovine carotid artery graft was very efficient to give a good access to circulation for hemodialysis. There was no evidence of local or cardiovascular complications associated with fistulas.
Subject(s)
Acute Kidney Injury/therapy , Arteriovenous Shunt, Surgical/methods , Renal Dialysis , Adolescent , Animals , Carotid Arteries/transplantation , Cattle , Child , Child, Preschool , Female , Femoral Vein/transplantation , Humans , Male , Saphenous Vein/transplantation , Transplantation, Autologous , Transplantation, HeterologousABSTRACT
A case is reported of a female preschool, age child with nephrotic syndrome, probably secondary to focal and segmentary hyalinosis with progressive decrease of the renal function. The patient was given increasing doses of furosemide to control the important retention of fluids she showed until a daily dose of 120 mg/kg. of body weight was reached. Adequate control of edema was managed and it was possible to decrease sodium restriction from the diet when urinary excretion of sodium increased. Such effect was useful for four months during which, the patient's diet turned more adequate and there was improvement of the nutritional state which was seriously impaired because of the restrictive diet given. However, control was lost because the patient died at home from bronchopneumonia. Thus, it is considered furosemide may be used in chronic renal failure at higher than usual doses in selected patients.
Subject(s)
Furosemide/administration & dosage , Kidney Failure, Chronic/drug therapy , Body Weight , Child , Drug Evaluation , Female , Furosemide/adverse effects , Furosemide/therapeutic use , HumansABSTRACT
Six uremic dhildren in periodic hemodialysis with protein-calorie malnutrition were studied. Three of them were given diet supplementation with a compound constituted by carbohydrates and essential amino acids. Evaluation at ,3 and 6 months with somatometry, rutine laboratory analysis, intravenous glucose tolerance test and plasma amino acid determinations, showed that patients with diet supplementation had a slight increase in height and body weight, improved glucose in tolerance, that was initialy detected, and an abnormal pattern of plasma amino acids not modified during the study. Patients without diet supplementation showed no changes in height, body weight, glucose tolerance and plasma amino acids. These results suggest that diet supplementation with carbohydrates and amino acids is useful to improve nutrition in uremic children on hemodialysis, but it is neccesary to study more patients.
