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[Acute renal insufficiency]

L Velásquez-Jones1, R Muñoz-Arizpe

  • 1Departamento de Nefrología, Hospital Infantil de México Federico, Gómez, México, D.F.

Boletin Medico Del Hospital Infantil De Mexico
|September 1, 1993
PubMed

Insights

Acute renal failure (ARF) is common in children due to dehydration, toxins, and sepsis. Reliable diagnostic tests like fractional excretion of sodium help manage complications such as electrolyte imbalances and reduced kidney function.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine

Context:

  • Acute renal failure (ARF) incidence is rising in pediatric populations, particularly neonates.
  • Factors contributing to ARF include diarrheal dehydration, nephrotoxic agent exposure, and sepsis.
  • Increased survival of critically ill neonates in intensive care units contributes to higher ARF occurrence.

Purpose:

  • To review diagnostic indices for ARF in children.
  • To discuss functional abnormalities and complications of pediatric ARF.
  • To outline management principles and treatment strategies for ARF complications.

Summary:

  • Diagnostic markers for pediatric ARF include urine-to-plasma urea and creatinine ratios, osmolality, fractional excretion of sodium (FENa), and renal failure index (RFI).
  • FENa and RFI are identified as the most reliable diagnostic tests.
  • Common complications encompass reduced glomerular filtration rate, azotemia, hyponatremia, hyperkalemia, metabolic acidosis, hypocalcemia, hyperphosphatemia, and hypermagnesemia.

Impact:

  • Highlights the importance of early and accurate diagnosis of ARF in children.
  • Provides a comprehensive overview of ARF pathophysiology and clinical manifestations in pediatric patients.
  • Guides clinicians in managing complex electrolyte and acid-base disturbances associated with pediatric ARF.

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