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Percutaneous renal biopsy was done in 15 infants and children with third degree marasmus and in five normal controls. All the cases were free from infection. Histopathological changes as shown in sections stained with hematoxylin and cosin include patchy areas of colloid degeneration and thickening of the walls of some blood vessels in 10 out of 15 marasmic cases. Some proximal convoluted tubules appeared small or atrophic, others are somewhat dilated with decreased thickness of their walls, while others showed necrotic changes. The distal convoluted tubules in the medulla appeared vacuolated and distorted. The activity of the enzyme succinic dehydrogenase (SDH) is markedly inhibited especially in the distal convoluted tubules in all the patients studied.
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