[Acute renal insufficiency in children. Retrospective study of 89 cases]

Between 1982 and 1992, 89 patients aged six months to 15 years were treated for acute renal failure at the Ibn Rochd Teaching Hospital. There were 51 males (57%) and 38 females (43%). All patients received conservative treatment. Fifty-eight patients (65%) required dialysis at the acute phase. The dialysis technique used was peritoneal dialysis in 22 cases (25%) and hemodialysis in 36 (40%). Twenty-nine patients received emergency dialysis for severe sodium and water overload and/or severe hyperkalemia. In the other cases, dialysis was initiated because of high blood urea and creatinine levels; before dialysis, blood urea exceeded 33 mmol/l (2 g/l) in every case and mean urea level was 51 mmol/l. Causes of acute renal failure included glomerulonephritis (n = 46), hemolytic uremic syndrome (n = 12), acute interstitial nephritis (n = 9), urinary tract obstruction (n = 5), and renal hypoperfusion (n = 11); in six cases, no cause was identified. Mortality rate was 17%. Recovery rate was higher in the subgroup of patients without anuria. Outcome was favorable in 65.5% of patients with glomerular disease. Most patients in this study did not require intensive care and none had post-cardiac surgery or neonatal acute renal failure which are known to carry a poor prognosis.