[The value of diagnostic laparotomy in patients with malignant lymphomas]

From 1972 to 1974 a collaborative prospective study was undertaken to determine the incidence, causes and clinical course of chronic renal failure (CRF) in pediatric patients (age 1/2-16 years) in Switzerland. In addition, information concerning the occurrence of terminal CRF observed between 1967 and 1971 was obtained. CRF is defined as persistently elevated serum creatinine greater than 2 mg/100 ml. The small size of Switzerland (population 6.27 million) and the availability of specialized medical care favoured relative completeness of data.

a) Non-terminal CRF. - Prevalence was 4.5 per million total population = 18.5 per million children (1/2-16 years old)(n = 28 at 31. 12. 1974); Causes: renal disease was acquired in 14% and congenital in 86% (hereditary nephropathies excluding polycystic kidneys 4%, polycystic kidneys 14%, hypoplasia 14%, urinary tract abnormalities 54%). Progression of CRF: mean time interval in which serum creatinine doubled was, in the group of acquired renal diseases, 8.3 months (n = 6); in hereditary nephropathies 14.3 months (n = 4); in the group of polycystic kidneys and hypoplasia 41.2 months (n = 6), and in patients with urinary tract abnormalities 35.8 months (n = 15). Body height was reduced in all groups as compared with normal children: 1.0 SDS (standard deviation scores) in acquired renal diseases (n = 9), 5.1 SDS in cystinosis (n = 2), 0.4 SDS in polycystic kidneys (n = 4), 1.6 SDS in hypoplasia (n = 5), and 2.3 SDS in urinary tract abnormalities (n = 16). b) Terminal CRF. - Mean yearly incidence (1967-1974, n = 68) was 1.36 per million total population = 5.6 per million children (1/2-16 years). Causes: In contrast to the situation in non-terminal CRF, acquired diseases were observed in 56% of all patients. Hereditary nephropathies were found in 12%, polycystic kidneys in 1.5%, hypoplasia in 4.5%, and urinary tract abnormalities in 26%.

Between 1970 and 1972, 7 of 21 patients, and during 1973/1974 13 of 1n. On 31. 12. 1974, 18 of these 20 treated patients were alive, and of these 14 had a functioning graft.