Reduced taste function and taste papillae density in children with chronic kidney disease.

Background: Taste loss may contribute to the loss of appetite in children with chronic kidney disease (CKD) and other serious medical conditions that result in malnutrition. Traditional methods for measurement of taste loss commonly use aqueous tastant solutions that can induce nausea, vomiting, or even pain in the mouth. An alternative is to measure fungiform papillae density on the anterior tongue since this correlates with taste sensitivity.

Causes and outcome of late referral of children who develop end-stage kidney disease.

Aims: This study aims to characterise the timing of referral to a paediatric nephrology unit of children who develop end-stage kidney disease (ESKD). This study also aims to determine whether late referral (LR) influences outcomes and to explore factors that may lead to LR.

Methods: A retrospective case review of all incident patients with ESKD who received renal replacement therapy (RRT) at a single paediatric centre.

Smell and taste function in children with chronic kidney disease.

Loss of appetite and poor growth are common in children with chronic kidney disease (CKD), and changes in smell and/or taste function may be responsible, but the hypothesis has not been proven. This aims of this prospective age- and gender-controlled study were to determine whether: (1) changes in smell and taste function occur in children with CKD; (2) smell or taste dysfunction are associated with estimated glomerular filtration rate (eGFR); (3) there is an association between smell or taste loss and body mass index (BMI). The study cohort consisted of 72 children of whom 20 were CKD stage 3-5 patients, 12 were CKD stage 2 patients, 20 were clinical controls (CC) and 20 were healthy children (HC).

Acquired facial palsy with hypertension secondary to Guillain-Barre syndrome.

Most cases of facial nerve paresis are idiopathic (Bell's palsy). However, rare and potentially dangerous conditions may present in this manner. We report 2 children presenting with unilateral lower motor neuron facial nerve palsy and hypertension.

Renal length discrepancy by ultrasound is a reliable predictor of an abnormal DMSA scan in children.

A renal length discrepancy (RLD) of more than 10 mm by ultrasound (US) is accepted as a potential indicator of an underlying renal pathology; however, there are few supporting data for this in children. Our objective was to determine a cutoff at which RLD on US is a reliable predictor of dimercaptosuccinate acid (DMSA) scan abnormality. We present data from 90 patients who had both renal US and a DMSA scan, as well as DMSA scan results compared with bipolar RLD by US.

The choice of threshold limits for pediatric ambulatory blood pressure monitoring influences clinical decisions.

Objectives: Hypertension in children may be defined by blood pressure elevated above the 95th percentile according to sex and age. Population data for ambulatory blood pressure provide different age-related and sex-related threshold limits to office-derived data. We sought to determine whether, when using ambulatory blood pressure monitoring in a clinical setting, changing 95th percentile threshold limit sets from office-derived to ambulatory blood pressure-derived would lead to different diagnostic decisions.

Agreement on reporting of ambulatory blood pressure monitoring in children.

The use of ambulatory blood pressure monitoring (ABPM) can improve the accuracy of paediatric BP measurement and may better correlate with end-organ injury than office BP measurement. However, the interpretation of ABPM may be influenced by several variables. We sought to ascertain the agreement among three paediatric nephrologists when reporting 92 ABPM sessions performed on patients aged 5 to 18 years.

Cyclosporine formulation and Kaposi's sarcoma after renal transplantation.

Background: Transplantation enhances the risk of malignancies, due to the chronic use of antirejection medication. In the case of Kaposi's sarcoma (KS) the permissive effect of immunosuppression has been extensively studied, and cyclosporine (CsA) appears to play a key role. Here we have compared the incidence of KS in transplant patients receiving Neoral or Sandimmune as a part of their immunosuppressive therapy.

Renal scintigraphy unraveled the diagnostic dilemma of antenatal hydronephrotic solitary kidney-crossed renal ectopia.

On antenatal ultrasound assessment, an apparently solitary hydronephrotic kidney was identified, confirmed on postnatal ultrasound examination. More detailed postnatal investigations revealed the diagnosis of crossed renal ectopia.

Retinoic acid may increase the risk of bone marrow transplant nephropathy.

Bone marrow transplant nephropathy (BMTN) classically presents more than 100 days after transplantation as an acute nephritis with hypertension, azotaemia and anemia that usually results in end stage renal failure (ESRF). The risk of developing BMTN may be greater with the use of more intensive chemotherapy and higher total body and tumor bed irradiation. Cis-retinoic acid (RA) may further increase the risk of developing BMTN.

Collection under paraffin is not necessary for stability of urine pH over 24 h.

Collection of urine under paraffin is routinely used in clinical practice for urine pH evaluation. To examine whether the accuracy of pH measurement is adversely influenced by the method of collection and storage, we divided each urine specimen and sent one aliquot to the laboratory under paraffin and another in a sealed 5-ml plastic syringe. In another experiment we evaluated the stability of urine pH measurement in a clinical setting.

Clinical, histopathologic, and genetic studies in nine families with focal segmental glomerulosclerosis.

Background: Familial forms of focal segmental glomerulosclerosis (FSGS) are caused by mutations in genes at 1q25-31 (gene for steroid-resistant nephrotic syndrome 2 [NPHS2]), 11q21-22, 19q13 (gene for alpha-actinin 4 and NPHS1), and at additional unidentified chromosomal loci.

Methods: We describe clinical and histopathologic features and results of linkage analysis in nine consecutive index cases with familial FSGS who, together with their families, were referred for genetic studies.

Results: Two of the index cases presented in childhood (22%) and seven cases presented in adolescence or adulthood (78%).

Atorvastatin treatment for hyperlipidemia in pediatric renal transplant recipients.

The objective of this prospective study was to determine the prevalence of hyperlipidemia in our pediatric renal transplant patients and to treat those with persistently elevated cholesterol and/or low-density lipoprotein (LDL) levels. All patients with a functioning renal allograft for greater than 6 months were studied (n = 18). Patients with cholesterol and/or LDL levels greater than the 95th percentile (n = 9) were commenced on an HMG-CoA reductase inhibitor, Atorvastatin and monitoring was performed for efficacy and adverse effects.

The relationship between serum creatinine, serum cystatin C and glomerular filtration rate in pediatric renal transplant recipients: a pilot study.

Serum cystatin C more accurately reflects glomerular filtration rate (GFR) in pediatric renal transplant recipients than serum creatinine. Nineteen pediatric renal transplant recipients, 15 male and 4 female, ranging in age from 8.35 yr to 19.