Controlled trial of chlorambucil in frequently relapsing nephrotic syndrome in children (a preliminary report).
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Biomedical subjects
Publications and source records attributed to H Alatas.
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In 15 children with advanced chronic renal failure, glomerular filtration rate was determined by different methods. Inulin clearance correlated well with the mean of creatinine and urea clearance, and also with 51-chromium edetic acid (EDTA) clearance measured over 24 hours. The absolute values of creatinine clearance and of 51Cr-EDTA clearance measured up to 8 hours were higher than inulin clearance. In advanced renal failure both the 51Cr-EDTA clearance measured over 24 hours, and the mean of creatinine and urea clearance, provide acceptable estimates of true glomerular filtration rate.
Twenty children with severe renal hypertension caused by renovacular lesions or chronic renal failure were treated with verapamil. The application of the drug as a single intravenous injection (0.1 mg/kg) during hypertensive crisis was followed by a drop of the systolic blood pressure which was highest 30 min after injection (--25% of the original value). In order to normalize the blood pressure during prolonged hypertensive crisis verapamil was used successfully as an intravenous infusion. For the long-term treatment of renal hypertension verapamil was given orally with success, alone or combined with other antihypertensive drugs. Verapamil has a lowering effect on the blood pressure even in the presence of advanced renal failure. Prolongation of atrioventricular conduction time is the most important side effect of the drug when given in high doses and, especially, when combined with digitalis.
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The aim of this paper is to report the hospital prevalence of chronic renal failure, the spectrum of the various underlying diseases and the outcome of these patients managed with conservative treatment. The diagnosis of chronic renal failure was established either on the first hospital admission or during the course of the disease. During the period of three years (1986-1988), 489 cases of various renal diseases were admitted to the Dr. Cipto Mangunkusumo Hospital in Jakarta. Twenty-one cases (4.3%) with chronic renal failure were diagnosed and in 18 out of them (85.7%) the underlying diseases could be established while in the remaining three cases (14.3%) the primary renal diseases were uncertain. All patients were managed conservatively and none of them were treated either by regular dialysis or renal transplantation. Eight patients (38.0%) died during follow up, another five cases (23.8%) were still under routine control, while the remaining eight (38.0%) were lost on follow up.
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