Related Experiment Videos
Presentation, management, complications, and outcome of acute renal failure in childhood: five years' experience
Insights
This study reviewed 72 acute renal failure cases in children, finding renal hypoperfusion as the main cause. Availability of maintenance dialysis significantly reduced mortality rates in pediatric acute renal failure patients.
Area of Science:
- Pediatric Nephrology
- Renal Medicine
Background:
- Acute renal failure (ARF) in children presents significant management challenges.
- Understanding the etiology and outcomes of ARF is crucial for improving pediatric care.
Purpose of the Study:
- To analyze the causes, treatments, and outcomes of acute renal failure in pediatric patients.
- To evaluate the impact of dialysis availability on ARF mortality in children.
Main Methods:
- Retrospective review of 72 episodes of ARF in 70 children (aged ≤16 years) treated between 1971-1975.
- Analysis of common causes, including renal hypoperfusion, hemolytic-uremic syndrome, glomerulonephritis, and congenital abnormalities.
- Assessment of dialysis modalities (peritoneal dialysis, hemodialysis) and associated complications.
Main Results:
- Renal hypoperfusion was the most frequent cause (31 cases), followed by hemolytic-uremic syndrome (12 cases).
- Dialysis was employed in 44 cases, with peritonitis and fluid balance issues being common complications.
- Mortality decreased from 33% to 20% over the study period, attributed to the introduction of maintenance dialysis.
Conclusions:
- Early recognition and prompt transfer are vital, though delays were noted in some cases.
- Maintenance dialysis significantly improved survival rates for pediatric ARF.
- Future access to dialysis and transplantation programs may be limited by financial constraints.
Abstract:
During 1971-5, 72 episodes of acute renal failure were treated in 70 children aged up to 16 years. The commonest causes were renal hypoperfusion (31 cases), haemolytic-uraemic syndrome (12), glomerulonephritis (9), septicaemia (5), and congenital abnormalities (6). Though referral from other hospitals was generally prompt, 10 out of 51 patients had been observed for up to seven days before transfer. Dailysis was used in 44 cases, the most common complications of which were peritonitis in those treated with peritoneal dialysis and acute changes in fluid balance in those treated with haemodialysis. Altogether 37 patients fully recovered, 10 were discharged with chronically impaired renal function, 17 died, and six entered the dialysis and transplantation programme. The mortality fell from 33% in 1972 to 20% in later years, which was due solely to maintenance dialysis being available. Though all patients with irrevocable kidney failure who were suitable entered the dialysis and transplantation programme, with current financial restrictions we doubt whether we shall be able to find places for all such patients in the future.