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Aetiology and outcome of acute and chronic renal failure in infants

Mirja Wedekin1, Jochen H H Ehrich, Gisela Offner

  • 1Department of Pediatric Nephrology, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|January 10, 2008
PubMed

Insights

Infants with acute or chronic renal failure (ARF/CRF) have high mortality, but renal replacement therapy offers good survival chances for those without severe comorbidities. Kidney transplants in infants show promising long-term outcomes.

Area of Science:

  • Pediatric Nephrology
  • Renal Medicine
  • Infant Health

Background:

  • Analyzed aetiology and outcomes of acute renal failure (ARF) and chronic renal failure (CRF) in infants.
  • Retrospective study of children under 1 year with serum creatinine >100 mumol/l.

Purpose of the Study:

  • To evaluate the causes and survival rates of infants with ARF and CKD.
  • To assess the effectiveness of renal replacement therapy (RRT) in this population.

Main Methods:

  • Followed 119 infants (<1 year) with elevated creatinine (1997-2004).
  • Classified 70 infants with ARF and 49 with chronic kidney disease (CKD) stages 3-5.
  • Documented causes of renal failure, treatments (dialysis, kidney transplant), and outcomes.

Main Results:

  • Congenital diseases caused 41% of renal failure; acquired diseases caused 59%.
  • ARF causes included cardiac, prematurity, and septic conditions; 37% mortality unrelated to kidney function.
  • For CKD, 21/49 infants received dialysis; 23/49 underwent kidney transplant (RTx) with 95.5% 5-year survival. Non-RTx CKD survival was 63%.

Conclusions:

  • Renal replacement therapy provides good survival for infants without life-threatening comorbidities.
  • Infant survival with CKD treated in the first year rivals that of older children.
Abstract

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