Subcutaneous recombinant human erythropoietin (rHuEpo) treatment of renal anemia was performed in four boys and eight girls on CAPD, aged 0.8-12.5 (mean 7.4) years. In contrast to previous studies, our therapeutic goal was not set with a hematocrit of 30% but with full correction of anemia. Following a maximum weekly rHuEpo dosage of median 120 (range 100-240) IU/kg body weight, hematocrit increased in 10 children from 24 (14-29)% within 12 (4-17) weeks to 40.1 (33.5-48.4)%. The weekly increase in hematocrit was 1.27 (0.5-3.1)%. The corrected reticulocyte count increased from 1.3 (0.7-1.8)% to 2.3 (1.4-3.9)% within 4 (2-6) weeks. Eight children fulfilled the protocol; six with an uncomplicated course were able to maintain a hematocrit of 37.1 (35.1-42.7)% with only one sc medication per week of approximately two-thirds of their highest weekly rHuEpo dosage. No serious adverse effect of rHuEpo therapy was observed.

In 30 children with renal allografts the diagnostic validity of pulsed Doppler (PD) versus colour coded Doppler (CD) sonography was assessed prospectively. 46 PD examinations were performed calculating the resistive index (RI) in the segmental arteries in comparison to 46 CD scans, where renal blood flow throughout the grey-scale image was displayed. In addition, point-spectral analysis with calculation of the RI was also performed on the CD scans. The time for examination ranged from five to ten minutes for the PD and from three to five minutes for the CD study. Concordant findings for the PD and CD technique were generally obtained (normal blood flow pattern on PD-excellent visualization of renal blood flow on CD, reduced or reversed diastolic flow on PD-poor visualization of renal blood flow on CD). There was close correlation of the RI values obtained by the PD and CD scans. CD sonography facilitated point-spectral analysis in shortening the time for examination. The ability to visualize focal hemodynamic alterations provided a higher diagnostic accuracy in comparison to PD sonography.

Oral glucose tolerance tests (50 g/m2 body surface) were performed in fifty-two children and adolescents (28 girls and 24 boys) aged 3.1 to 16.8 (mean +/- SD 11.4 +/- 3.28) years. Mean overweight of the patients was calculated to be 69.7 +/- 28.5%. Plasma glucose and immunoreactive insulin were determined before, and 15, 30, 60, 90, 120 and 180 minutes after the oral glucose load. According to the criteria of the National Diabetes Data Group six (11.5%) of the subjects had abnormal glucose test profiles (fasting glucose concentrations over 140 mg/dl or after 120 minutes above 140 mg/dl), and in four of the six probands we could detect elevated fasting insulin levels (above 17 E/ml) as well. In twenty-three out of forty-eight serum samples (47.9%) basal insulin levels were elevated. No correlation between age, sex, duration of overweight with glucose or insulin levels could be found. Our results are in accordance with findings in obese adults reflecting a high prevalence of impaired glucose tolerance and hyperinsulinemia in obese children and adolescents. On the other hand pathophysiologic relevance and clinical importance of these findings in obese children of an impaired glucose tolerance and hyperinsulinemia is questionable in view of the rapid normalization after weight loss.

U n i v e r s i t y o f Hamburg, 0-2000 Hamburg 20, FRG. P a t i e n t s with c l a s s i c a l HUS (n=22; median age 2;2 y r s ) were p r o s p e c t i v e l y s t u d i e d a t o u r i n s t i t u t i o n s i n c e 1986. SLT-association was e s t a b l i s h e d by c y t o t o r i c i t y a s s a y s o f f e c a l f i l t r a t e s , b a c t e r i a l i s o l a t i o n o r colony-blot-hybridizati-o n w i t h SLT-specific DNA probes. S e r i a l serum samples from 1 2 p t s and a p p r o p r i a t e c o n t r o l s were s t u d i e d f o r SLT I and I1 n e u t r a l i z i n g a n t i b o d i e s (NAB) and f o r h e m a g g l u t i n a t i n g a n t i b od i e s (HA) u s i n g e r y t h o c y t e s c o a t e d with p u r i f i e d LPS from E . c o l i 0157:H7 and o t h e r s e r o v a r s . SLT a s s o c i a t i o n was demonstrated i n 13/22 c h i l d r e n 159%); E.coli i s o l a t e s (n=6 p t s ) included serogroups 026, 055, 0111 and 0157; f e c a l SLT a l o n e was p r e s e n t i n 7 a d d i t i o n a l c a s e s . 4 p t s developed r i s i n g NAB-titers a g a i n s t SLT I o r 11; 9 p t s (75%) p r e s e n t e d w i t h h i g h LPS-0157-HA a t t h e time o f t h e d i a g n o s i s o f HUS t h a t r a p i d l y d e c l i n e d d u r i n g convalescence.Thus i n N o r t h e r n Germany a n a s s o c i a t i o n o f t h e c l a s s i c a l HUS w i t h in-vivo SLT p r o d u c t i o n h a s been confirmed. D e t e c t i o n o f LPS-0157-AB a p p e a r s t o be a new, v a l u a b l e s e r o l o g i c a l marker f o r t h i s subgroup o f HUS. F u r t h e r s t u d i e s a r e needed t o e l u c i d a t e a p o s s i b l e p r o t e c t i v e o r pathogenic r o l e o f SLT-and LPS-specific AB. Sauer. Sophia Children's Hosp., Rotterdam. The Netherlands. Furmulas specially designed for preterm infants contain up to 50% MCT because of their almost complete absorption. The effects of ,MCT(C8 and C10) on mineral absorption were studied in infants receiving formula (Nutricia,Holland) with 5%(LCT group) or 40C,(MCT group) of fat as MCT, providing 80 mg P-, I52 mg Ca-and 120 kcal/kg.d,+ 600 IU/day vit D. 72 hr balance studies were performed at 4 weeks of age. Values:mean 2 lsd or median with interquartile range. Plasma levels (MCT vs LCT) of Ca(2.42 0.1 vs 2.4f 0.1 mmol/L). P(2.2f 0.3 vs 2.320.2 mmol/L) and Alkaline Phosphatase ( 2 7 3 2 7 4~s 295f43 IU/L) were in the normal range. NITROGEN AND FAT DEPOSITION IN PRETERhI INFANTS FEDMCT on regular dialysis therapy (II). 34 after uanrplanution (Ul):variation of EPO concentration in children with these various slager of chronic renal failure (CRF) were compved to 40 conuols with nomcnal ancmia(1V)and healthy conuols ( V) .-0: relative EPO deficiency could be detected in I and less after renal mansplanration , an absolute deficiency wrr found on regular dialyris.An inverse linear melation between EPO levels and hemoglobin in IV Q E C W C~ however in Il the rise of EPO war LuuEciat mmpared to 1V.h our swdy we could demomuate successfully a feedback mechanism between EPO...

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