INDICATION OF INTRINSIC RENAL DISEASE IN AZOTEMIC INFANTS WITH DIARRHEA AND DEHYDRATION

In an effort to differentiate transient renal impairment from more serious forms of renal disease in infants presenting with diarrhea and dehydration, serial blood urea nitrogen (BUN) values were obtained during rehydration. These were plotted against time on semilogarithmic paper. It was found that the BUN fell linearly with time. The half time (HT) of the BUN fall off, the time taken for the admission BUN to fall by 50%, was estimated from the graph. In patients with no intrinsic renal disease the half time was between 6 and 24 hours, mean half time was 15 hours. Of nine children who had half times in excess of 24 hours, six had proven renal disease as manifested by oliguria, hematuria, or obstructive uropathy. This technique, the plotting of serial BUN values during rehydration, is suggested as a clinical method in evaluating the significance of azotemia in infants presenting with diarrhea and dehydration.</jats:p

GRANULOMATOUS COLITIS IN CHILDREN: A STUDY OF 25 CASES AND COMPARISON WITH ULCERATIVE COLITIS

Twenty-five children with granulomatous colitis were followed for a mean of 17 years to determine natural history and late results. In all the children the rectum was initially free of disease. Complications occurred in 84% and only three patients responded favorably to a medical program. Surgery was required in 68% (74 operations in 17 patients). Following 14 ileocolostomies there was proximal spread of disease in 7 and distal spread in 8 after varying periods. Nine ultimately required ileostomy, which also was no protection against proximal extension. The prognosis was worse when the terminal ileum was originally involved. The high incidence of postoperative complications and proximal extension encourages persistence in medical therapy, contrary to the attitude in managing ulcerative colitis in children. The surgical procedure of choice when the rectum is free of disease is an ileocolostomy, since anticipated extension might not occur for a prolonged period of time.</jats:p

TOTAL BODY EXCHANGEABLE WATER, SODIUM AND POTASSIUM IN "HOSPITAL NORMAL" INFANTS AND CHILDREN

Total body exchangeable potassium is approximately 40 mEq./kg. of body weight in infants, children and young adults alike, in contrast to exchangeable water and sodium which are high per unit of body weight at birth and decrease to adult levels during the first 2 years of life. "Cell potassium concentration" calculated from exchangeable water, sodium and potassium and serum sodium concentration changes little during the period of growth and development despite other large alterations in body composition. These measurements are suggested as a further means of investigating cellular potassium status in vivo.</jats:p