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Published on: February 2, 2021
Acute renal failure in moroccan children
Amal Bourquia1, Fatima Chakib, Abdessadek Jennah
1Al Amal, Centre de Néphrologie et Dialyse Pédiatriques, Casablanca, Morocco.
Insights
This study on childhood acute renal failure (ARF) in Morocco found acute glomerulonephritis was the most common cause. Recovery was higher in non-oliguric patients, with favorable outcomes for most glomerular disease cases.
Area of Science:
- Pediatric Nephrology
- Renal Medicine
- Epidemiology
Background:
- Acute renal failure (ARF) in children presents unique etiological and prognostic challenges.
- Understanding the specific causes and outcomes of ARF in diverse populations is crucial for effective management.
Purpose of the Study:
- To investigate the causes and prognosis of acute renal failure in Moroccan children.
- To analyze treatment modalities, including dialysis, and their impact on outcomes.
Main Methods:
- Retrospective analysis of 120 pediatric ARF cases from Casablanca, Morocco (1982-1999).
- Data collection included patient demographics, causes of ARF, treatment received (dialysis type and indication), and patient outcomes.
- Etiologies analyzed included acute glomerulonephritis, hemolytic uremic syndrome, renal hypoperfusion, and urinary tract obstruction.
Main Results:
- The primary cause of ARF was acute glomerulonephritis (50.8%), followed by hemolytic uremic syndrome (15%).
- 74% of patients required dialysis, with hemodialysis being more common than peritoneal dialysis.
- Mortality rate was 17%; recovery was more favorable in non-oliguric patients and those with glomerular disease (65% favorable outcome).
Conclusions:
- Acute glomerulonephritis is the leading cause of ARF in Moroccan children.
- While dialysis is frequently required, outcomes are generally favorable for glomerular disease, particularly in non-oliguric cases.
- The study highlights the importance of identifying specific etiologies for improved pediatric ARF management.
Abstract:
To evaluate the etiology and prognosis of acute renal failure (ARF) in Moroccan children, we retrospectively studied 120 cases of ARF that presented to two centers in Casablanca, Morocco between 1982 and 1999. There were 72 (60%) boys and 48 (40%) females with age that ranged between six months and 15 years with a mean of 6.8 +/- 5.0 years. All patients received appropriate medical treatment, while 76 (74%) patients required dialysis; peritoneal dialysis in 31 (40%) patients and hemodialysis in 45 (60%). Emergency dialysis was performed in 37 (48.7%) patients due to severe sodium and water overload and/or severe hyperkalemia, while dialysis was initiated in 39 (51.3%) because of high blood urea and creatinine levels. Predialysis serum urea nitrogen (BUN) exceeded 33 mmol/l in all of these cases and the mean was 51 mmol/l. The causes of ARF included acute glomerulonephritis (GN) in 61 (50.8%), hemolytic uremic syndrome (HUS) in 18 (15%), renal hypoperfusion in 12 (10%), acute interstitial nephritis in 9 (7.5%), urinary tract obstruction in 7 (5.9%) and the cause was not identified in 13 (10.8%). Mortality rate was 17%; recovery rate was higher in the non-oliguric patients. Outcome was favorable in 65% of the patients with glomerular disease. Most patients in this study did not require intensive care and none had neonatal ARF, which is known to carry poor prognosis.
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