Iron homeostasis in relapsing steroid-sensitive nephrotic syndrome of childhood.

AIM: Urinary transferrin loss is a typical feature in relapse of the idiopathic nephrotic syndrome, however, the impact on serum iron homeostasis and hematological parameters has not been studied systematically so far. PATIENTS AND METHODS: Therefore, we investigated serum iron (Fe), erythropoietin (EPO), ferritin (FN), transferrin (TF), total iron-binding capacity (TEBK), transferrin saturation and the soluble transferrin receptor (sTFR) combined with hematological parameters (hemoglobin, MCV, MCH) in 42 children with relapsing, steroid-sensitive nephrotic syndrome (NS) in remission (RM, n = 26) and relapse (RL, n = 16), including 13 patients who were studied in both states. Thirty-three age-matched healthy children served as controls. RESULTS: Fe, TEBK and TF were significantly reduced in RL compared to RM in cross-sectional as well as in paired studies while ferritin, hematological parameters and EPO levels remained unchanged. A significant increase, however, of the soluble transferrin-receptor could be demonstrated in cross-sectional analysis comparing RL to RM and healthy controls (3568+/-713 mg/ml vs 2625+/-576 vs 2646+/-697; p < 0.001 respectively) as well as in paired analysis of 13 patients in RL and RM (p < 0.001). CONCLUSION: We conclude that transient transferrin and iron deficiency occurs in RL of INS but this seems to be counterbalanced by upregulation of the sTFR, a mechanism that might be important in preventing the development of iron deficiency anemia during the active nephrotic state.

Hypertension among Nigerian children

A prospective study on hypertension in childhood among Nigerian children was carried out in five centres. Four hundred and four children had complete data and were admitted into this study; out of which 226 (55.9 per cent) were males and 173 (44.1 per cent) were females. Twenty-two of the children examined were hypertensive with blood pressure more than 120/80mmHg; which was maximal in the age range 10-12 years. Females were more affected than males. Thirty-six of the children have their systolic blood pressure above 140mmHg

Schistosoma haematobium: a neglected common parasitic disease of childhood in Nigeria. Incidence and intensity of infection.

A prospective and cross-sectional study was carried out in various communities in Kwara State, Nigeria, to access the status and implications of urinary schistosomiasis among schoolchildren. Of 425 pupils examined in nine communities, 193 (45.4%) were infected. Infection rates for boys (44.7%) and girls (47.9%) were not significantly different (p greater than 0.5). Children between 11 and 13 years of age had the highest incidence rates (33.6%). However, the percentage of children (25.9%) excreting at least 1000 eggs per 10 ml of urine sample during their first decade of life was significantly higher (p less than 0.01) than for older pupils. The health implications of schistosomiasis acquired early in life, as in this study, are highlighted in the discussion.

[The diagnostic value of captopril radionuclide nephrography for renovascular hypertension in childhood]. / Diagnostische Bedeutung der Captopril- Radionuklidnephrographie für die renovaskuläre Hypertonie im Kindesalter.

In four children the role of captopril-radionuclide nephrography in the diagnosis of renovascular hypertension was studied. Captopril (0.5-1.0 mg/kg orally) did not affect Iodine-123 Hippuran nephrography in two children with mild renal artery stenosis, but induced an accumulation of the tracer within the kidneys in two children with hemodynamically significant renal artery stenosis. As in adults Iodine 123 Hippuran nephrography appears to be a useful tool to identify patients with significant renal artery stenosis.

The impact of a UNICEF-assisted rural water project on the prevalence of guinea worm disease in Asa, Kwara State, Nigeria.

This paper demonstrates that protected water supplies, in the form of boreholes, can reduce the prevalence of dracunculiasis (guinea worm disease) in affected communities from a point prevalence of greater than or equal to 50% to 0% or near 0% within 3 years of intervention. Studies in Nigeria show that boreholes sited within a village and used exclusively for drinking water are most effective, while less accessible or malfunctioning boreholes have a less dramatic impact on prevalence. In contrast to the situation in villages served with boreholes, the prevalence of guinea worm in the unserved villages remained almost unchanged. The rapid benefits of protected rural water supplies and the decline of dracunculiasis, including the rise in school enrollment and fall in the rate of school absenteeism, are highlighted together with other socioeconomic benefits.