Serum sodium abnormalities in children.
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Child↗
Biomedical subjects
M S Polinsky
Publications and source records attributed to M S Polinsky.
Encephalopathy in infants and children with chronic renal disease.
The examination of five pediatric patients with encephalopathy secondary to chronic renal failure has indicated a stereotyped sequence of neurologic signs and symptoms including ataxia, loss of motor abilities, myoclonus, seizures, dementia, and bulbar dysfunction. Both the patients with CNS dysfunction and a control group selected for a similar degree of renal failure had increased levels of serum phosphate, alkaline phosphatase, and parathyroid hormone. Serial EEGs in the affected group revealed progressive slowing and an increase in paroxysmal features. No specific neuropathologic findings were noted in one patient.
Brain Diseases↗
Uric acid in childhood essential hypertension.
Serum uric acid concentrations and the fractional excretion of uric acid were determined in 31 children from 3 1/2 to 18 years of age with essential hypertension. While on an unrestricted sodium intake, elevated serum values of uric acid were found in 13 of 31 (42%) of the children. After ingesting a low-sodium diet (200 mg/day) for three days, mean serum uric acid values increased by 0.7 mg/dl (P less than 0.001). There was a significant inverse correlation between the serum uric acid concentrations and fractional excretion of uric acid during the normal and low-sodium diet. This study indicates that the major factor leading to hyperuricemia in our hypertensive patients was a decrease in urate clearance. Insofar as hyperuricemia may represent a cardiovascular risk factor, this abnormality already exists in a significant fraction of hypertensive children and adolescents.
Adolescent↗
Development aspects of peritoneal dialysis kinetics in dogs.
To determine whether solute transfer during peritoneal dialysis is age related and to identify those factors which might explain age-related differences in dialysis kinetics, the peritoneal dialysance of [14C]urea (DU), [3H]inulin (DI), and the permeability index (DR = DI/DU) were examined in six puppies and five adult dogs. Exchange volume of lactated Ringer's (40 ml/kg) and exchange times (30 min) were identical in all studies. Theoretical calculations for urea dialysance for animals of differing body size were made. Assuming the existence of a similar functional peritoneal surface area per kg and the use of similar exchange volumes per kg and dwell times, theoretical values for the urea dialysance per kg for different sized animals were identical. The experimental studies demonstrated that DI per kg and DU per kg were higher in the puppies (0.146 +/- 0.023 and 0.765 +/- 0.054 ml/min kg; X +/- S.E.) than in the adult (0.052 +/- 0.01 and 0.462 +/- 0.05 ml/min/kg) (P less than 0.01). Also, DR was higher in the puppies (0.187 +/- 0.026), than in the adults (0.11 +/- 0.015) (P less than 0.05). The greater values for DI and DU per kg and DR in the young are best explained by the young having an increased peritoneal membrane permeability as well as an increase in functional peritoneal surface area relative to body weight. This increase in solute movement is independent of the dialysis mechanics used in an exchange and reflects age-related differences in the intrinsic characteristics of the peritoneal membrane.
Age Factors↗
Cefazolin in children with renal insufficiency.
Cefazolin (7 mg/kg) were administered to 11 children with renal insufficiency and to ten children on hemodialysis. The serum half-life of the drug was progressively prolonged as glomerular filtration rate fell. The serum half-life of cefazolin was variably prolonged in those children on hemodialysis, but their serum levels of cefaxolin had dropped by 35 to 65% during dialysis. Most had no measurable level prior to the next dialysis. Dosage recommendations are made for both groups of patients.
Adolescent↗
Age related changes in urea-C14 peritoneal dialysance.
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Age Factors↗
Fusarium peritonitis in a child on peritoneal dialysis: case report and review of the literature.
OBJECTIVE: To review various aspects of the management of peritonitis due to Fusarium, a soil mold which infrequently causes infections in humans. DATA SOURCES: A case of Fusarium peritonitis in a child on chronic peritoneal dialysis (PD) is presented. The child developed Fusarium peritonitis 2 weeks after an episode of bacterial peritonitis. His Tenckhoff catheter was removed, and he was maintained on hemodialysis while receiving intravenous amphotericin. Following 2 weeks of treatment with amphotericin, he was successfully returned to PD. A literature review of all previously reported cases of Fusarium peritonitis was then conducted to determine features common to infections caused by Fusarium. Emphasis was also placed on unique characteristics of the organism that may affect patient management, as well as patient characteristics that may increase the risk for infection by Fusarium. RESULTS: Fusarium may cause infection in immunosuppressed individuals, such as cancer patients or patients on chronic PD. The organism has a propensity to attach to foreign bodies such as intravascular and intraperitoneal catheters. Therefore, successful treatment of infections caused by Fusarium may require catheter removal in addition to systemic antifungal therapy. CONCLUSIONS: This report presents the first known case of Fusarium peritonitis in a child. In view of the difficulties posed by this unusual organism, optimal therapy of Fusarium peritonitis should consist of immediate catheter removal and treatment with systemic antifungal drugs.
Child, Preschool↗