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What decides: high mortality in paediatric acute renal failure?
1Institute of Medical Sciences, Banaras Hindu University, Varanasi.
Insights
This study on pediatric Acute Renal Failure (ARF) found that delayed treatment, malnutrition, and severe anemia contributed to a high 65% mortality rate in young children. Early intervention is crucial for improving outcomes in pediatric ARF cases.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
Background:
- Acute Renal Failure (ARF) in children presents diverse etiologies.
- Delayed presentation with prolonged oligoanuria is common in pediatric ARF cases.
Purpose of the Study:
- To analyze the clinical profile, management, and outcomes of pediatric ARF cases.
- To identify factors contributing to high mortality in pediatric ARF.
Main Methods:
- Retrospective analysis of 40 pediatric ARF cases.
- Evaluation of clinical presentation, laboratory findings, and treatment modalities.
Main Results:
- 60% of patients were under 4 years old, with male predominance.
- 87.5% had severe anemia (mean Hb 7.73 g/dL); 40% were underweight.
- Marked hypoalbuminemia was observed in all assessed cases; 65% mortality rate despite peritoneal dialysis.
Conclusions:
- Delayed hospital presentation (2-7 days of anuria) significantly impacts outcomes.
- Malnutrition, severe anemia, and hypoalbuminemia are critical factors in pediatric ARF mortality.
- Effective peritoneal dialysis did not significantly reduce mortality due to delayed presentation and severe comorbidities.
Abstract:
Forty paediatric cases of A.R.F. (Acute Renal Failure) of various aetiology were included in the study. 60% of patients were less than 4 years of age with male predominance. 80% cases reported to us very late with oligoanuria of more than 24 hours (2-7 days). Diarrhoea, vomiting and fever were other dominant symptoms. Maximum cases were severely anaemic (87.5%) with mean Hb 7.73 +/- 1.9 gm%. 40% cases were of underweight while only one case (2.5%) was of over weight, inspite of volume excess in 40% cases. All 24 cases, who were estimated for serum albumin, found to have marked hypoalbuminemia. Mortality was found to be as high as 65% inspite of effective peritoneal dialysis in all cases. High mortality seems to be due to profound anuria of many days (because of marked delay in reaching the hospital), fever and malnutrition besides other factors as aetiology.