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Acute renal failure in the pediatric age group - single center prospective study of 180 cases

P R Shah1, J Falodia, V B Kute

  • 1Department of Nephrology and Clinical Transplantation, Dr. H. L. Trivedi Institute of Transplantation Sciences - Smt Gulabben Rasiklal Doshi and Smt Kamlaben Mafatlal Mehta Institute of Kidney Diseases and Research Centre, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India. drpankajrshah@yahoo.com

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|September 14, 2011
PubMed

Insights

Acute renal failure (ARF) in children is common in the Indian subcontinent. Acute tubular necrosis is the primary cause, with peritoneal dialysis proving effective for renal replacement therapy.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine

Background:

  • Acute renal failure (ARF) is a frequent pediatric emergency, with distinct etiological profiles in the Indian subcontinent.
  • Understanding local patterns of ARF is crucial for effective management.

Purpose of the Study:

  • To prospectively investigate the etiology, clinical presentation, and outcomes of ARF in pediatric patients in India.
  • To evaluate the effectiveness and safety of peritoneal dialysis as a primary renal replacement therapy.

Main Methods:

  • A prospective study of 180 pediatric patients with ARF admitted between August 2006 and March 2008.
  • Data collection included patient demographics, ARF etiology, treatment modalities (peritoneal dialysis and hemodialysis), and outcomes.

Main Results:

  • Acute tubular necrosis was the leading cause of ARF (30% intrinsic renal disease).
  • Peritoneal dialysis was the preferred initial treatment for dialysis-requiring patients; hemodialysis was used in six cases.
  • Mortality was significantly higher in infants (<1 year) (40%) compared to older children (11.3%), with an overall mortality of 17.7%.

Conclusions:

  • ARF is a significant concern in pediatric nephrology within this region.
  • Peritoneal dialysis is a safe and effective renal replacement therapy for pediatric ARF.
  • Poor prognostic factors include delayed referral, malnutrition, infections, young age (<1 year), and multiorgan involvement.

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