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Biomedical subjects

C Feldhoff

Publications and source records attributed to C Feldhoff.

10 recordsLinked to original sources
PubMed1999

[Quality of life following renal transplantation in childhood].

The goal of renal transplantation is to achieve the best possible quality of life in patients with terminal renal failure. To evaluate some aspects of quality of life in patients with renal grafts during childhood of our center, data on medical, educational and professional rehabilitation were collected retrospectively. Between 1972 and 1997 135 renal transplantations had been performed in 123 patients below the age of 18 years. 12-year graft survival of patients transplanted before 1983 figured at 21% and rose to 62% during the following years, after introduction of cyclosporine A into the immunosuppressive regimen. The proportion of patients in the respective age group attending a secondary school (16%) was lower and of those attending elementary school (71%) or a school for disabled and handicapped children (11%) was higher than usual in the German population. But, 83% of all patients reached a school degree. After school 78% proceeded with a vocational training or university. 89% of patients completing professional training were employed at last observation as compared to only 60% of those who never finished a professional training. Renal replacement therapy starting already during the early phase of education is difficult to coordinate with normal schooling. Considering these health- and time-related obstacles, the degree of educational and professional rehabilitation of the patients is good. But, there is a need for special support accompanying educational and professional training.

Adolescent↗
PubMed1984

[Integrated treatment of children with chronic renal insufficiency].

Early diagnosis of chronic renal failure in childhood is difficult, since the course of CRF shows in children with congenital renal diseases unspecific symptoms. The active cooperation of the practical pediatrician with a pediatric nephrologist enables this team for prevention of complications of chronic uremia. The integration of treatment between general pediatrician and specialist also prevents long hospitalisation and makes the prevention of the child for the best mode of treatment possible, i.g. ambulant hospital dialysis, home dialysis or CAPD. Pediatric dialysis should be performed in one of the established 14 pediatric dialysis centres in our country, because psychological, somatic and technical problems in children differ from those in adults. In dialysed children the general pediatrician should be further involved in treatment and may contribute worthy help in medical (control of drug compliance, hypertension) and psychosocial (school, employment) care of the chronic sick children. Even after successful renal transplantation the local pediatrician should continue to be involved in patient care, in spite of more frequent check up controls at hospital.

Humans↗
PubMed1984

A comparison of alternate day and daily steroid therapy in children following renal transplantation.

The effects of switching from daily steroid therapy (DST) to alternate day steroids (ADST) was reviewed in 28 children following kidney transplantation. Fifteen of the 28 children could be pair matched for age, sex, height and weight at transplant, time after transplant and renal function with children on DST. We found that catch-up growth occurred in children less than 10 years of age on low dose DST in the first 1 or 2 years post-transplant as long as major growth retarding factors such as renal failure or nephrosis were absent. Switching to ADST resulted in a significant increase in growth velocity in the second year on ADST compared to the parallel time in the matched pairs on DST. However, no significant increase occurred in the first year on ADST and for the total period of ADST which averaged 3.2 years. There was a similar risk of acute rejection episodes and rising serum creatinine levels in the matched ADST groups. However, late episodes of violent acute rejection leading to rapid graft loss were seen only in the ADST group, as long as 6 years post-transplant. Thus, ADST compared to low dose DST offers little growth advantage and, perhaps, this therapy should be reserved for children growing poorly after transplant.

Adolescent↗
PubMed1984

Hemolytic uremic syndrome in 3 siblings.

Three female infants in a single family developed a hemolytic uremic syndrome (HUS) at nearly identical ages, 11 1/2, 12, and 16 months respectively, years apart from each other. The course of the disease was characterized by slow onset, gradual deterioration and prolonged anuria in 2 siblings, hypertension and fatal outcome in all cases. A genetic predisposition for this type of familial HUS is probable and should be taken into account in genetic counseling.

Disease Susceptibility↗
PubMed1983

Survival time in cystinosis. A collaborative study.

In a retrospective study the overall survival time of 205 cystinotic patients of six countries was determined. The median survival time was 8.5 years. The median time for 'renal death' (age at death due to uraemia or age at starting renal replacement therapy) was 9.2 years. The youngest patient dying of renal death was 5.2 years. No sex difference in survival time was noticed. Furthermore no difference in survival time was noted between the different countries. The analysis of the overall survival curve indicates no clear differences between the infantile and adolescent types of cystinosis.

Adolescent↗
PubMedDate not supplied

[Peritonitis and infection in children with idiopathic nephrotic syndrome].

We analyzed episodes of peritonitis and/or sepsis associated with the idiopathic nephrotic syndrome (ns) in 23 children treated between 1975 and 1985 at our clinic. 37.5% of the children with infantile ns, 16% of those with steroidsensible ns, and 13.6% of those with steroidresistant ns developed peritonitis. Children with infantile ns and one girl with gram-negative secondary peritonitis presented with sepsis. 3 septic children died. Four patients developed peritonitis secondary to intestinal perforation. The most common bacterial pathogen in primary peritonitis was S. pneumoniae (7 patients). 7 cases were culture-negative. All episodes of peritonitis coincided with an active nephrotic syndrome: in more than half of the patients therapy with corticosteroids had already been started. Eight patients underwent surgical exploration for presumed appendicitis, but none was confirmed by histological examination of the appendix. In 2 instances S. pneumoniae was cultured from ascitic fluid. Prophylactic polyvalent pneumococcal vaccination and early start of corticotherapy during the acute illness of ns is warranted.

Abscess↗
PubMedDate not supplied

[Kidney transplantation in childhood].

40 renal transplantations on children up to 15 years of age have been performed in our hospital in the years 1976 to June 1982 with one exception in 1972. We did verify the findings of previous authors that renal transplantation in children has produced good results so far (1, 5, 6). Dialysis treatment in children often evokes extreme problems for the patients, parents, and medical team. Considering this dialysis is seen as only a provisional measure, transplantation however as the final aim in the therapeutic concept of children with terminal renal insufficiency (1). Furthermore dialysis treatment for infants is justified in our opinion only if a renal transplantation ca be realized.

Adolescent↗
PubMedDate not supplied

Growth disparity in monozygotic twins discordant for chronic renal disease.

Growth data in seven pairs of monozygotic twins only one twin affected by renal disease are given. The data suggest that renal disease not only retards normal growth and sexual maturation but also affects growth potential. Therefore evaluation of the effect of renal disease and its treatment on growth should include estimation of the genetic potential for growth.

Adolescent↗