PEDIATRICS Vol. 52 No. 2 August 1973, pp. 197-205
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INDICATION OF INTRINSIC RENAL DISEASE IN AZOTEMIC INFANTS WITH DIARRHEA AND DEHYDRATION

Charles B. Brill M.D.1, Stanley Uretsky M.D.1, and Donald Gribetz M.D.1

1 Department of Pediatrics, Mount Sinai School of Medicine of The City University of New York

In an effort to differentiate transient renal impairment from more serious forms of renal disease in infants presenting with diarrhea and dehydration, serial blood urea nitrogen (BUN) values were obtained during rehydration. These were plotted against time on semilogarithmic paper. It was found that the BUN fell linearly with time. The half time (HT) of the BUN fall off, the time taken for the admission BUN to fall by 50%, was estimated from the graph. In patients with no intrinsic renal disease the half time was between 6 and 24 hours, mean half time was 15 hours.

Of nine children who had half times in excess of 24 hours, six had proven renal disease as manifested by oliguria, hematuria, or obstructive uropathy. This technique, the plotting of serial BUN values during rehydration, is suggested as a clinical method in evaluating the significance of azotemia in infants presenting with diarrhea and dehydration.

Submitted on November 20, 1972
Accepted on January 11, 1973