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A Child With Anuric Acute Kidney Injury With Subsequent Hypertensive Encephalopathy: A Case Report
Shauna Tarsi1, Badar Goraya2, Lin Liu3
1Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA.
Insights
Pediatric acute kidney injury (AKI) can resolve with medical management alone, even with prolonged anuria. This case shows that dialysis is not always necessary for acute post-streptococcal glomerulonephritis, supporting individualized treatment.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
Background:
- Acute kidney injury (AKI) is a serious condition in children, associated with high morbidity and mortality.
- Dialysis (renal replacement therapy or RRT) is a critical intervention for severe AKI but not universally required.
- Acute post-streptococcal glomerulonephritis (ASPGN) can cause AKI and anuria in pediatric patients.
Abstract:
Acute kidney injury (AKI) is a critical condition in pediatric patients, often leading to significant morbidity and mortality. While dialysis is a key intervention in severe cases, it is not always required. This case report presents a pediatric patient admitted with AKI and anuria secondary to acute post-streptococcal glomerulonephritis (ASPGN). The patient underwent medical management, including intravenous fluids and diuretics, without requiring dialysis. Despite 72 hours of anuria, the patient achieved full renal recovery without renal replacement therapy (RRT). This case highlights the importance of individualized treatment approaches and supports the notion that anuria alone is not an absolute indication for dialysis. Delaying RRT in hemodynamically stable patients, in the absence of emergent indications, may be a viable approach. At the five-year follow-up, the patient had fully recovered without residual renal impairment.
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