Related Experiment Videos
Insights
Infant renal failure remains a serious condition with limited therapeutic options and a high mortality rate. Congenital anomalies significantly worsen the prognosis for infants with kidney failure.
Area of Science:
- Pediatrics
- Nephrology
- Neonatology
Background:
- Persistent renal failure in infants under one year of age presents a critical health challenge.
- The prognosis for infants with renal failure has not shown the same improvement seen in adults.
- Congenital renal or urinary tract anomalies are frequently associated with infant renal failure.
Purpose of the Study:
- To evaluate the prognosis of persistent renal failure in infants.
- To determine if infant renal failure outcomes have improved similarly to adult outcomes.
- To identify factors influencing the prognosis of renal failure in this age group.
Main Methods:
- A review of all persistent renal failure cases in infants under one year of age over a ten-year period.
- Uniform therapeutic approaches were applied to 52 infants.
- Infants were categorized into two groups: those without and those with congenital renal or urinary tract anomalies.
Main Results:
- Infants with congenital anomalies had a significantly poorer prognosis (9% recovery) compared to those without (42% recovery).
- Renal failure causes in infants without anomalies included hypotension, shock, pyelonephritis, and sepsis.
- In infants with anomalies, renal failure was primarily due to renal dysplasia, agenesis, or urinary tract obstruction, often with co-occurring serious anomalies.
Conclusions:
- Infant renal failure, particularly when associated with congenital anomalies, carries a high mortality rate.
- Therapeutic interventions for complex congenital anomalies leading to renal failure are limited.
- No significant improvement in the prognosis for infant renal failure is anticipated in the near future.
Abstract:
All cases of persistent renal failure in infants less than 1 year of age were reviewed to determine whether the prognosis has improved equally for infants as for adults. During a ten-year period, 52 infants were treated by applying uniform therapy; 28, more than half, were less than 4 weeks old. All cases were separated into two groups; 19 infants without and 33 infants with congenital renal or urinary tract anomalies. In 20 patients of the latter group, additional serious anomalies of other organs were present. The age distribution was strikingly different: in 18 of 21 infants, renal anomalies were present, as diagnosed on the first day of life. In contrast, only 3 of 11 infants, 4 to 12 months old, had urinary tract anomalies. In infants without renal anomalies, renal failure was caused by hypotension or shock in 10 of 19 cases, by pyelonephritis or sepsis un 6 of 19. Of this group, eight infants (42%) recovered completely, nine (47%) died. Death occurred within one to two days of hospitalization in all but three cases, caused by shock or sepsis. In this group medical problems that are amenable to therapy have caused either renal failure or contributed to the infant's death. In infants with renal or urinary tract anomalies, renal failure was caused by renal dysplasia or agenesis in 16 of 33 infants, by urinary tract obstruction in 12 of 33. Only three patients (9%) recovered, all older than 4 months, 20 (61%) died, and 10 are living with signs of chronic renal failure. Death usually occurred within one week of hospitalization and, in 16 of 20, it was caused by renal failure and multiple additional anomalies. The multiplicity and complexity of the congenital anomalies in most instances precluded effective, lifesaving therapy. Renal failure in infants is still a serious disease accompained by a high mortality rate in which therapeutic possibilities are limited. No improvement in prognosis can be expected in the near future. Pediatrics, 59:987-994, 1977, RENAL FAILURE, CONGENITAL RENAL ANOMALIES, INFANT, ISCHEMIC RENAL DAMAGE.