SUMMARY One hundred and fourteen children with primary nephrotic syndrome were followed up prospectively for periods of between 5 and 14 years. Urine samples from 94 of them became proteinfree during the initial 8-week course of prednisone, and the outcome for these children was good: 74 of them have been free of symptoms for at least 3 years, 18 have had relapses during the last 3 years, and only one child still has proteinuria. All these children have normal renal function and blood pressure. One child died accidentally. Twenty children did not respond to the initial prednisone treatment. Thirteen of them had remissions later, of whom 2 have had relapses during the last 3 years. Seven were totally resistant to prednisone 4 of whom died in renal failure, the remaining 3 have persistent proteinuria with normal levels of creatinine; one has high blood pressure too. Remission during the initial treatment indicated a good prognosis, but two-thirds of the initial non-responders also fared well.

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252 infants and children were followed for 2 years after their first urinary tract infection. Each symptomatic infection was determined by simple laboratory examinations as upper pyelonephritic or lower urinary tract infection. I.v. urography was done at the beginning of the follow-up and 2 years later; micturating cystourethrography was taken after the third infection at the latest. Urological abnormalities were found in 26 patients (10%), and 12 subjects (5%) developed renal scars during the study. Patients, who had their first upper urinary tract infection before the age of 12 months, numbered 93, and 19 of them had urological abnormalities and 10 scars. Two renal scars occurred among the 71 subjects with their first pyelonephritic infection after the age of 12 months. No renal injury was detected in the 88 infants and children with lower symptomatic urinary tract infection or asymptomatic bacteriuria. The determination of the level of the infection may be a useful aid in detecting the harmful scar-forming urinary tract infections. Infants with a pyelonephritic infection are at high risk, and in need of an early urological evaluation.