Aspects of Brazilian paediatric nephrology.

Brazil is a large country with different population densities in its five geographical regions, each of which has severe but unevenly distributed socioeconomic problems which affect the health care system. This makes the accurate assessment of renal disease in the large paediatric population which comprises 40% of the total population especially difficult. This paper analyses the experience of one paediatric nephrology unit. Urinary tract infection affecting 44% of the patients was the most common disease. There was a high incidence of vesicoureteric reflux and renal scarring. The proportion of poststreptococcal glomerulonephritis did not exceed 11%, whilst nephrotic syndrome in its various forms represented 20% of the patients. End-stage renal failure was common and difficult to manage. Renal transplantation could not meet the demand for a variety of reasons, thus there has been an alarming annual increase in the number of patients on dialysis. Other diseases encountered in smaller numbers included acute renal failure, other glomerulopathies (mainly IgA), tubulopathies and renal lithiasis.