Acute Renal Failure in Children Below 12 Years Causes, Clinical Presentation and Management


ABSTRACT:BACKGROUND:Acute renal failure (ARF) is a common condition in hospitalized patients, characterized by a rapid fall in glomerular filtration rate (GFR), carries a high morbidity and mortality, often preventable, so rapid recognition and treatment may prevent irreversible loss of nephrons.OBJECTIVE:To find out the cause of acute renal failure in children and to study the clinical presentation and management modalities and sequel.METHODS:A prospective study done in Central Teaching Hospital for children from January 2006 to December 2006. 120 patients aged 1month- to 12 years who were diagnosed and treated as cases of acute renal failure were collected & analyzed. And the distribution of patients according to (age, sex, type of presentation, laboratory finding, type of management and sequel) were done.RESULTS:From hundred twenty patients, there were 77 male and 43 female with 1.7:1 ratio distributed into 93 infant, 14 preschool and 13 school age group .The main type of presentation was acidosis ,oliguria & dehydration. The main causes were gastroenteritis, sepsis and obstructed uropathy in infancy and preschool children, glomerular disease in school age group. 97 need conservative treatments and 23 need urgent peritoneal dialysis (PD) with mortality rate 5.15%, 30.51% respectively.CONCLUSION:Acute renal failure occurred more in infancy and most of them were prerenal acute renal failure can be handled with conservative treatment; peritoneal dialysis is a good choice for treatment of acute renal failure not resolved by conservative therapy.