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Forty-two oliguric neonates were prospectively studied to evaluate the usefulness and reliability of various diagnostic indices in differentiating renal failure from functional (prerenal) oliguria. Twenty-two infants had functional oliguria, 16 had renal failure, and four infants had probable early renal failure. Statistically significant differences between functional oliguria and renal failure were found with regard to the urine sodium, urine to serum ratios of sodium, urea, and creatinine, renal failure index, and fractional excretion of sodium. However, sharp demarcation of the two groups was possible only when the renal failure index or fractional excretion of sodium was used. Fractional excretion of sodium values of 2.5 or greater seem to differentiate renal failure from functional oliguria in this study.

Ontario. T~p o n . by Donald Fraser). To d i f f e r e n t i a t e medically t r e a t a b l e causes of hypertension from those requiring s u r g i c a l intervention. 9 renal transplant recipients (aged 15-19 y r s ) f u l f i l l i n p t h e following c r i t e r i a were inveatip.ated: a) a t l e a s t 3 months a f t e r transplantation. b) o r i g i n a l diseased kidneys removed, c) no evidence of r e j e c t i o n d) e t e r o i d dosage a t low l e v e l s . According t o s i t t i n g d i a s t o l i c BP and response t o antihypertensive drups t h e patients were divided i n t o 3 groups ( I ) severe, (11) moderate and (111) no HT (3 p a t i e n t s i n each). A l l patients i n proups I and I1 demonstrated a l l o g r a f t r e n a l a r t e r y s t e n o s i s (RAS) by arteriography. the X lumlnal occlusion being more pronounced i n t h e group I ( 250% The incidence, course and time of onset of s k e l e t a l abnormali t i e a cawed by chronic r e n a l f a i l u r e (CRF) a r e not c l e a r i n rapidly growing young children. To study these featurea we investigated t h e a k e l a t a l s t a t u s of 12 children under 5 years of aRe (mean age 2.5 yrs) who had mild t o moderate degrees of CRP (serum c r u t i n i n e (S.Cr) 0.9 -5.5 &dl). Seven p a t i e n t s had low growth velocity; 4 had obvious s k e l e t a l deformities. Major ossaous derangements were detected on radiographs i n 7 p a t i e n t a , and were present i n the i l i a c c r e s t bone biopay apecimena i n a l l 12 patients. Radiographic evidence of r i c k e t s appeared e a r l y (within 1.9 y r s a f t e r detection of CRF, m u n S.Cr 2.4 mgldl). Normal placrma 25-OH vitamin D l e v e l s ruled out vitamin D deficiency. I n contrast. X-ray signs of secondary hyperparathyroidism appeared l a t e r (mean duration of CRF 3.2 yrs. mean S.Cr 3.5 mgldl). Rickets responded readily t o vitamin D therapy (1600-5000 IU/day) but secondary hyperparathyroid lesions were refractory t o conventional d i e t a r y and medical management, including l a r g e doses of vitamin D (up t o 20,000 IU1d.y). Progressive bone disease constituted t h e reason f o r a h i t t i n g 3 of our p a t i e n t s t o t h e transplant program. We conclude t h a t renal osteodyatrophy i a an unexpectedly common occurrence i n very young children and may represent a major complication even before CRP becomes advanced.GLQMERULhR PEPMEABILITY I N AVMLOCOUS IMMUNE COMPLeX 1083 (AIC) NEPHRITIS. Ingelfinger, J u l i e R., Schneeberger Eveline E. and Grupe, Warren E., Dept of Pods, Children's Hompital Medical Center, Boston, Massachusetts.Glomeryier permaability t o neutral polydisperse polyvinylpyrrolidone I (PW) was studied i n Foreman r a t s with and without autologous i m u n e complex glomarulonephritis (AIC). The Foreman r a t generally develops milder disease than other s t r a i n s . However, a l l AIC r a t s studied were nephrotic with proteinuria i n excess of 50mg/24 hra. PW clearance (MW 8000-85000) was determined by column chromatography and compared t...

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