Cat-scratch disease (CSD) is a relatively common acute and benign infectious disease caused by

The clinical features of eight patients, four females, aged 4 to 15 years under chronic hemodialysis for terminal renal failure (creatinine clearance 10 ml-min-1,73 m 2 or less) are reported. Initial diseases were Alport syndrome, systemic lupus erythematosus, chronic glomerulonephritis (n = 2), bilateral polycystic kidney, prune belly syndrome and reflux nephropathy (n = 2). Distal vascular approach by means of arteriovenous fistulas was prefered for these patients and the kinetic urea model was used to evaluate the performance of the procedure. Patients required nine to twelve hours of hemodialysis per week for optimal results. Mean weight decreases of 1 to 3 kg and reductions in blood urea nitrogen and serum potassium of 40 mg-dl and 2,5 mEq-1, respectively, were observed. The main complications of hemodialysis were the desequilibrium syndrome, infections at the site of insertion of the arteriovenous fistulae and congestive heart failure. Three patients were submitted to renal transplantation with live donnors homografts: one died and the other two remain alive but under chronic hemodialysis. Five children are attending school regulary, and two of them are waiting a kidney donnor for transplantation. Despite encouraging results chronic hemodialysis in children constitutes only primary supportive therapy prior to renal transplantation. (Key words: chronic hemodialysis, renal failure).Se han requerido varies afios para que el de 1960 aparecieron trabajos en EUA 1 ' 2 y Frantratamiento de la insuficiencia renal terminal cia 3 , mostrando que no habia razon para que el (IRT) con dialisis y trasplante sea aplicado procedimiento no se empleara en nifios. A pesar regularmente en el nifio. A partir de la decada de las dificultades te"cnicas mayores que las obser-.. vadas en el adulto, estas y los problemas psicolo-1. Unidad de Nefrologia, Hospital LuisCalvo Mackenna. gicos lograron superarse.

No abstract

Idiopathic hypercalciuria. Urinary calcium/creatinine ratiosIn 50 children with hematuria or urolithiasis and idiopathic hypercalciuria, and in 15 control children, urinary calcium/creatinine concentration rates were measured after fasting and after calcium loading. Patients were classified into two groups depending on the results of an orally administered calcium loading test. Children were considered to have absortive hypercalciuria (42%) when they had low fasting urinary calcium/creatinine concentration ratio (0.28), Patients were labeled as renal hypercalciuria (32%) if they had high fasting urinary calcium/creatinine concentration ratio (>0,21), and variable increases of it after calcium overload. A third group of children (26%), were not classifiable by means of this test. Our data support the contention that this simple ambulatory test is very useful in the diagnostic workup of idiopathic hypercalciuria. (Keywords: hematuria, urinary calculi, hypercalciuria, idiopathic.) La hipercalciuria idiopatica ha cobrado creciente interns en los ultimos anos al demostrarse su relacion etiologica con la hematuria en porcentajes que oscilan entre 25 y 40% de los grupos estudiados 1 " 4 . For otra parte, su importancia en el estudio de las litiasis urinarias es reconocida desde que se determinara que entre 40 y 75% de los calculos compuestos por calcio son secundarios a este trastorno. 4 " 6 .El estudio sistematico de esta enfermedad fue iniciado por Pak en 1975, con su clasica descripcion de una prueba que permitio su clasificacion en los subgrupos absortivo y renal? con elementos fisiopatologicos propios, de relevante importancia para el enfoque terape"utico 7~u . Esta clasificacion ha sido discutida por distintos autores que no han confirmado los hallazgos originales, postulandose formas intermedias a partir de una teon'a unificadora de la hipercalciuria idiopatica, en que los fenomenos absortivos sen'an conse-1. Unidad de Nefrologia y Hemodialisis, Hospital Luis Calvo Mackenna.cuencia de las alteraciones metabolicas de origen renal 6 ' 12 " 15 . Este estudio tuvo como proposito evaluar prospectivamente en un grupo de pacientes hipercalciuricos la posibilidad de subdividirlos en los tipos absortivo y renal, segun su comportamiento en una prueba de restriccion y sobrecarga de calcio, basada en modelos ya descritos 6 ' 7 ' 10 ' 16 ' 17 , con el objeto de avanzar hacia un tratamiento racional de esta afeccion. MATERIAL Y METODOSSe evaluaron 50 pacientes hipercalciuricos detectados entre nines que consultaron por hematuria, litiasis o ambas, que en una muestra aislada de orina en ayunas tenfan un indice calcio/creatinina mayor a 0,21 o calciuria en orina de 24 h superior a 4 mg • kg • di'a (valores considerados como limite maximo normal en nifios). Se evaluaron como controles 15 pacientes sin hipercalciuria. Su distribucion por sexo y promedio de edad es descrita en la tabla 1. Las formas secundarias de hipercalciuria se excluyeron a traves de an...

Desmopressin acetate treatment for nocturnal enuresisabnormalities, who did -of respond lo imipramine and oxibutinir, acid, were treated with intranasal desmopressin ccetate 1 0 (jg • day followed by weekly increments of "0 jig per dose -when needed to achieve one wet episode or less per week ti I a f nal maximal daily dose of 40 fig. After three months under desmop^essin, 65% cr patient had one or less wet episodes per week and 62.2% of them did the same one month after the end cf therapy. No important side effects were delec'ed except by headache r a patient wrh antecedent migraine end normal neurological exanina'io'".