A pilot study of the Doppler renal arterial flow pattern was done in a group of 38 normal children, including 11 neonates age 2 weeks or less, 10 infants age 2 weeks to 1 year, and 17 children age 1 year and over. The appearance time, acceleration time, end-diastolic to peak-systolic velocity ratio (d/S), and diastolic to systolic flow ratio (A2/A1) increased with age. Another four patients with acute renal failure showed a characteristic absence of blood flow in the whole or late-diastolic phase. Diastolic flow reappeared with recovery. Doppler renal arterial flow pattern may be a noninvasive investigation of diagnostic and prognostic value.

Five infants with persistent hypoglycaemia due to hyperinsulinism were reported. Provocative tests for insulin release were unhelpful. Diazoxide was useful in the treatment of three patients but many side‐effects were observed. These included petechial rash, hypertrichosis, acute renal failure, fluid retention and cardiac failure. Two patients underwent spontaneous remission. Three patients had nesidioblastosis, two of whom were subjected to 95% pancreatectomy. Postoperatively, recurrence of hypoglycaemia was due to hyperinsulinism in one patient and to presumed glucagon deficiency in the other. Phenytoin effectively corrected the hypoglycaemia in the patient who had postoperative hyperinsulinism. It is recommended that medical therapy with diazoxide (10–15 mg/kg per day) together with a diuretic be commenced once hyperinsulinism is diagnosed. Subtotal pancreatectomy should be performed early in these patients if hypoglycaemia cannot be controlled with medical therapy or if side‐effects of treatment are documented.