Related Experiment Video
Updated: Aug 23, 2026
Analysis of Nephron Composition and Function in the Adult Zebrafish Kidney
Published on: August 9, 2014
Renal and post-renal causes of acute renal failure in children
1Department of Paediatrics, Dow Medical College and Civil Hospital, Karachi-75400, Pakistan. drasjpk@yahoo.com
Insights
Acute renal failure (ARF) is common in children under five, with males predominantly affected. Improving primary healthcare and prompt infection treatment can prevent over 90% of pediatric ARF cases.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
Background:
- Acute renal failure (ARF) is a significant concern in pediatric populations.
- Identifying specific causes and demographics affected by ARF is crucial for targeted interventions.
Purpose of the Study:
- To determine the primary causes of ARF in children under 12 years old.
- To identify the age groups and genders most susceptible to ARF.
- To analyze the etiological factors contributing to pediatric ARF.
Main Methods:
- A descriptive study was conducted over two years (1996-1998) at the National Institute of Child Health, Karachi.
- Included children under 12 presenting with ARF symptoms and laboratory confirmation (elevated BUN, serum creatinine, metabolic acidosis).
- Patients were categorized into two age groups (0-2 years and >2 years); transient pre-renal azotaemia cases were excluded.
Main Results:
- 119 pediatric ARF cases were identified, representing 1.36% of total admissions.
- The mean age of presentation was 4.5 years, with over 56% under five years old.
- Hemolytic uremic syndrome (54.34%) and septicemia (15.21%) were leading causes in younger children, while renal calculus disease (30.13%) predominated in older children. Over 90% of cases were infection-related.
Conclusions:
- Pediatric ARF is prevalent, particularly in children under five, with a notable male predominance.
- Effective primary healthcare and timely infection management are key to preventing over 90% of ARF cases in children.
- Early diagnosis and intervention are critical for managing pediatric ARF effectively.
Objective:
To identify the causes of acute renal failure (ARF) in pediatric population along with the identification of the age and gender most affected by the failure.
Design:
Descriptive study.
Place And Duration Of Study:
This study was carried out at the Pediatric Medical Ward of National Institute of Child Health (NICH), Karachi over a period of two years from 1996 to 1998.
Subjects And Methods:
The study included children under the age of 12 years who presented with signs and symptoms suggestive of ARF (oliguria/anuria, vomiting, acidotic breathing etc.) along with raised blood urea nitrogen (BUN) serum creatinine and metabolic acidosis as shown by arterial blood gases (ABGs). Patients were divided into two groups on the basis of age; group A consisting of 0-2 years and group B from >2 years. Patients presenting with transient pre-renal azotaemia were excluded from the study. After providing initial emergency cover, detailed history, physical examination and investigations were carried out according to a proforma specially designed to ascertain the cause of ARF. Patients were managed for ARF as per standard recommendations and investigations completed or repeated as and when required.
Results:
A total of 119 patients with ARF were admitted in the ward over a period of two years constituting 1.36% of the total admissions and 16.39% of the admissions due to renal pathology. Mean age of presentation was 4.5 years with 56.7% of the patients under the age of 5 years. Male predominance was noted in all ages with an overall male to female ratio of 2.3:1. Most common cause leading to ARF in younger age group was found to be hemolytic uremic syndrome [25(54.34%)] followed by septicemia [7(15.21%)]. In older patients renal calculus disease was the most common [22(30.13%)] underlying pathology followed by pre-existing, undiagnosed chronic renal failure [16(21.91%)]. More than 90% of cases were related, directly or indirectly, to infections.
Conclusion:
ARF is fairly common in children especially under the age of 5 years showing a male predominance. More than 90% of the cases can be prevented by improving primary health care and by early and prompt treatment of infections.
Related Concept Videos
01:29Acute Kidney Injury II: Pathophysiology
01:22Acute Kidney Injury I: Introduction
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:20Acute Kidney Injury V: Interprofessional Care
01:27Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
01:29Acute Kidney Injury III: Clinical Manifestations