Objective Over the past 10 years, we have collected data on pediatric patients less than 16 years of age from the National Registry of CAPD (continuous ambulatory peritoneal dialysis). We present our experience with this population. Design The database details the patient number, age, weight, height, outcome, cause of death, reason for terminating CAPD therapy, peritonitis, and catheter survival. Patients Of the 434 patients (239 males, 195 females), 37 patients (8.5%) were under 1 year of age and 164 patients (37.8%) were under 6 years of age. About half of the patients were less than 20 kg in weight, clearly indicating that CAPD was the treatment of choice in young children. The duration on CAPD for these patients was less than 2 years for 233 patients (54%), and was 5 years or more in 48 patients (11%). Results The outcome of the total patient population of 434 as of M ay, 1991, is as follows 229 patients (52.8%) were being successfully treated with CAPD, 47 patients (10.8%) died, and 78 patients (18.0%) received a kidney transplantation. The patient survival rate was 85.6% at 3 years and 81.7% at 5 years. The technique survival rate was 74.9% at 3 years and 63.5% at 5 years. The rate of peritonitis was one episode over 28.6 patient-months. The mean catheter duration was 1.68 years. Peritonitis rate, catheter survival rate, and the rate of tunnel infection were worse in children less than 6 years of age than in older children. Conclusion The excellent patient and technique survival rates indicate that CAPD is an effective treatment for children with end-stage renal disease in Japan. The high infection rates in younger children indicate that extra careful management is needed for this young age group.

Bacteriuria was screened among 28,202 healthy school children, 14,575 boys and 13,627 girls, by dipstick and dipslide methods and also by pour plate culture. The prevalence of bacteriuria was 0.06% in boys and 0.52% in girls after the third screening. A high rate of false negative results with the dipstick test and a high rate of false positive results with the dipslide culture method using Microstix‐3 were observed. About 60% of screened children continued to have bacteriuria persistently for 9 months after the third screening, which was followed by monthly urine cultures. Anomalies of the urinary tract were detected in 9 of 26 children with persistent bacteriuria.

Patients with NS have several disorders of calcium metabolism: hypocalcemia, hypocalciuria and probably decreased intestinal absorption of calcium. In order to evaluate the mechanisms responsible we have studied in 23 children, 3-12 years old, with NS and normal rend1 function, total and ionized calcium, calciuria, and blood levels of 25-hydroxyvitamin D and of Cc-protein.The studies were performed when proteinuria was>200 mglhlmq and repeated during remission of NS. The blood levels of 25HCC and of Gc-protein were significantly lower than that in normdl subjects (p<0.01) and there wds d direct correlation between albuminemia and pldsma levels of 25HCC, and an inverse correlation between the degree of proteinuria and 25 HCC. The loss of metabolites of vitamin D circulating bound to Gcproteins seems the main cause of the disorders in calcium metabolism observed in NS. parameter can be estimated from the data of intake, NAE can be predicted. In steady state conditions the urinary excretion of electrolytes correlates with their intestinal absorption, which can be estimated from intake and absorption rate. Absorption from the gut was estimated in the following way: Na + Cl: 100%; K: 90%; Ca: 0.17 x Ca intake (mg) + 60; Mg: 0.39 x Mg intdke (mg) -23; P: 0.642 x P intake (mg) -11. 75% of the ingested organic sulfur (methionine and cystine) is oxidized to SO dnd excreted in the urine. 03 excretion is almost independent ?rum the diet (38 meq/d/1.73m ). The usefulness of this theoretical model to estimate NAE was demonstrated in acid-base studies of children with phenylketonuria receiving two synthetic amino acid mixtures (PAM with a high NAE of 4-6 meq/kg/d, PAM74with a low NAE of 1 meq/kg/d).FAMILIAL HYPOKALAEMIA AND HYPOMAGNESAEMIA. GITELMAN'S SYNDROME. REPORT OF 6 CASES. McCredie, D.A., Powell, 3 H.R., and Rotenberg, E., Dept. of Paediatrics, University of Melbourne, Austrdlid.Six cases of renal wdsting of potassium and mdgnesium are described in four families. Four patients presented with tetany, whilst two were asymptomatic siblings of these. One patient also suffered from a progressive external ophthalmoplegia syndrome and mental retardation, whilst the remaining five were normal in physical and intellectual development. One patient (now aged 31 yrnrs) hns subsequently giver^ birth t o two r~urrn.al clllldrt,rx, but maintains very low serum levels of both potassium (2.0 mM) and magnesium (0.5 mM) when off electrolyte therapy. No abnormalities in calcium metabolism were found and there was no other evidence of tubular reabsorptive defect apart from slight defects in urinary concentration and acidification. In particular sodium chloride conservation appeared normal. Plasma renin levels were normal, or slightly raised in these patients and urinary aldosterone levels were normal, distinguishing this condition from Bartter's syndrome. Magnesium loading did not affect potassium wasting, nor did potassium loading alter the renal handling of magnesium. Spironolactone was able to improve tubular reabsorption of potassium, ...