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Richard N. Fine
Division of Pediatric Nephrology UCLA Center for the Health Guenees University of California, Los Angeles
Health Professions Medicine & Pharmacology

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Conservative Treatment of Chronic Renal Failure (CRF) Richard N. Fine
Paediatrica Indonesiana Vol 28 No 9-10 (1988): September - October 1988
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (285.786 KB) | DOI: 10.14238/pi28.9-10.1988.214-7

Abstract

The infant, child and adolescent who has irreversible impairment of renal function, regardless of the specific etiology, invariably experiences a progressive decline in glomerular filtration rate (GFR) over time. This decline in GFR can be attributed to an unremitting attack on the remaining unaffected nephrons by, the primary disease process such as in a patient with acquired immune complex disease, but the reasons for the progressive decline in GFR in patients with congenital diseases are more difficult to identify. Currently the hypothesis attributing the decline in GFR to damage to the remaining intact nephrons resulting from hyperperfusion is receiving increasing attention. Creation of CRF in the rat model by 7/8 nephrectomy leads to a rapid decline in GFR and focal glomerulosclerosis (FGS) in the previously normal glomeruli. This lesion of FGS is presumably a result of hyperperfusion of the remaining normal nephrons in order to compensate for the reduction in functioning renal mass.
Recent Advances in the Management of End-Stage Renal Disease (ESRD) in Children Richard N. Fine
Paediatrica Indonesiana Vol 28 No 9-10 (1988): September - October 1988
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (435.109 KB) | DOI: 10.14238/pi28.9-10.1988.218-22

Abstract

It has been almost 20 years since the initial report were published detailing the use of the dual treatment modalities of dialysis and renal transplantation to treat children with ESRD. During this time, the outlook for the infant, child and adolescent with ESRD has changed dramatically from abject pessimism to cautious optimism. Initially, hemodialysis was the principle dialytic technique utilized; however, intermittent peritoneal dialysis was used occasionally in selected centers. The latter required less technical expertise, but necessitated considerably more dialysis time and was significantly less efficient at alleviating the clinical and biochemical consequences of uremia.
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