Alteplase is significantly more effective than heparin in preventing clot formation in central haemodialysis lines. This reduces morbidity and improves preservation of central venous access. It is more expensive, though relatively economic if packaged into syringes and stored frozen until needed, but reduces the costs of unblocking or replacing clotted lines.

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Children with vesicoureteric reflux (VUR) are twice as likely to develop febrile urinary tract infections (UTI). Historically, there have been concerns that under treatment in this vulnerable group may lead to progressive kidney scarring resulting in chronic kidney disease and hypertension. This created an anxiety to identify VUR early, although these adverse sequalae have never been convincingly proven. [1][2][3][4] The prevalence of VUR in the normal young childhood population is commonly quoted as 1%, although a recent reanalysis suggests that it could be as high as 25%-40% gradually resolving by the age of 5 years. 5,6 In children less than two years old investigated after a first febrile UTI, VUR was found in 39% and approximately