The present study reports epidemiological data on renal disorders in children in Venezuela. Information was obtained from 14 centers for the period January through December 1998. A total of 3,624 patients were evaluated as either a first outpatient consultation or as a first hospital admission. Nearly 70% of the patients could be grouped in one of the following categories: (1) urinary tract infections (32%), with detection of abnormalities of the urinary tract in 25%, (2) metabolic disorders (28%), mainly idiopathic hypercalciuria and hyperuricosuria, (3) glomerulonephritis (9.5%). The other 30% corresponded to urolithiasis 7%; renal tubular acidosis 5.6%; nephrotic syndrome 4.5%; primary hematuria 4.2%; acute renal failure 2.8% (43% were secondary to acute dehydration, 15% to birth asphyxia, 14% to septicemia, and 23% to multiple factors); chronic renal failure 1.6% (secondary to glomerulopathies, predominantly focal glomerulosclerosis, structural abnormalities of the urinary tract, hereditary disorders, and renal hypoplasia/dysplasia); miscellaneous diseases 4.8%. Hence, the spectrum of renal disorders in Venezuela is wide, sharing similarities with countries of both the developed and developing world. These data will hopefully contribute to the development of national healthcare policies appropriate to the epidemiology of the country.

Patients and methods Two corticosteroid regimens were compared in a randomised, prospective study of 48 consecutive acute rejection episodes occurring at least one month after transplantation in 22 children who had received renal allografts. The higher dose schedule (intravenous methylprednisolone 600 mg/M2 daily for three days) was no more effective than the lower (oral prednisolone 3 mg/kg daily for three days) in reversing rejection, being successful in 70% as opposed to 72% of episodes. Few major side effects were seen with either treatment, but unpleasant sensations were reported much more frequently in the group given intravenous methylprednisolone; this regimen was also much more disruptive of the patient's life.Oral prednisolone in the dosage described is as effective as about 10 times that dose of intravenous methylprednisolone; it is much cheaper and is viewed as less unpleasant by patients.

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