Management of Acute Renal Failure in Infants and Children

Lieberman, Ellin

doi:10.1159/000180230

Cited by 30 publications

(3 citation statements)

References 6 publications

(6 reference statements)

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“…This was in agreement with Broyer et al in 1971 [7] and Liberman et al in 1972 [8]. However, Counhanan et al in 1975 [9] reported that renal hypoperfusion was the most common etiological factor of ARF.…”

Section: Discussionsupporting

confidence: 89%

“…Published data suggested a recovery rate of about 70% and 30% mortality [18]. In our series, 40% died or progressed to chronic renal failure whereas 28% of the Liberman series [8] and 23.6% of Counahan et al series [9] had a similar outcome (Table 3). This outlook for our children was due to those cases who continued to have variable degrees of renal failure rather than mortality.…”

Section: Discussionsupporting

confidence: 54%

See 1 more Smart Citation

Etiology, Presentation and Mangement of Acute Renal Failure in Saudi Children

et al. 1992

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One hundred children with acute renal failure (ARF) were admitted in our Nephrology Unit, Maternity & Children's Hospital over a four year period. Male patients outnumbered females with a ratio of 3:2. The ages of patients ranged from 1 month to 13 years with a mean age of 3.9 years. Fifty-five were suffering from intrinsic renal factors, 32 from post-renal and 13 were due to pre-renal factors. Among the intrinsic renal causes: acute glomerulonephritis (27 patients) and hemolytic-uremic syndrome (15 patients) were most common. Posterior urethral valve (20 patients) was the leading cause of post-renal failure. All pre-renal failure was due to diarrheal disease. Forty patients with ARF required dialysis (23 peritoneal dialysis, 17 hemodialysis). The remaining 60 patients were treated conservatively. The outcome in our patients were as follows: 60% cured, 29% continued to have variable degrees of renal failure and only 11% died. The latter was due to sepsis and cardiorespiratory failure. Acute renal failure (ARF) is not uncommon in children. The incidence varies from 4-22 per million population [1]. Intrinsic renal failure is the leading cause of ARF in developed countries [2], whereas pre-renal failure due to renal hypoperfusion is the leading cause of ARF in developing countries [3]. Post-renal failure occurs usually due to obstructive uropathy reported in 2% to 15% of children with ARF [4].No data are available from the Kingdom of Saudi Arabia regarding children presenting with ARF. We conducted this study in order to analyze the etiological factors, clinical presentation, response to the different modes of treatment and the outcome in 100 children admitted to our renal unit with this condition. Methods and MaterialsThe study included 100 children with ARF referred to our unit from different parts of the Kingdom over a period of four years. Children less than one-month-old were excluded from the study as the pattern of disease is different at this age.Acute renal failure was defined as a reduction in glomerular filtration rate "GFR" as manifested by oliguria (urine volume less than 300 ml/M2/day) or anuria (urine volume less than 1 ml/kg/day) and niore than 50% decrease in renal function as measured by serum creatinine (i.e. > 160 μmοΙ/L). Patients with normal urine output and increasing blood urea and serum creatinine were defined as having non-oliguric renal failure and included in this study [5].Pre-renal failure was diagnosed if the urine osmolality was more than 500 mosmol/L, urine urea to plasma urea concentration ratio more than five, fractional excretion of sodium "FeNa" less than 1% [6]. In cases we doubted a fluid challenge of 20 ml/kg of dextrose saline was given in order to differentiate between pre-renal and intrinsic renal failure. Initial diagnosis of post-renal failure was made by renal ultrasonography which was done routinely on all cases. Other investigations done at different stages of illness include renal isotope scan, micturating cystogram and transurethral endoscopy. Renal biopsy was done ...

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 54%

Etiology, Presentation and Mangement of Acute Renal Failure in Saudi Children

et al. 1992

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“…Numerous publications are available concerning the techniques used, indications for and complications and outcome of paediatric dialysis [1,13,14,16], but little is known about the long-term follow-up after renal function has been regained and acute dialysis has been discontinued. Only a few reports dealing with special entities, such as the haemolytic-uraemic syndrome, have mentioned this prognostic aspect [3,9,10,12,19].…”

Section: Introductionmentioning

confidence: 99%

Acute renal failure in children: prognostic features after treatment with acute dialysis

et al. 1986

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A 12-year review (1972-1983) is presented of 76 children who were dialysed because of acute renal failure. The causes of acute renal failure were mainly the haemolytic-uraemic syndrome (53%), trauma (16%) and operation (13%). Fifty-eight children (76%) survived, 18 children (24%) died. Fifty-two children, the majority suffering from haemolytic-uraemic syndrome, regained complete or partial renal function after a period of dialysis lasting between 1 and 57 days. One to 7.7 years after dialysis, clearance studies with inulin (CIn), p-aminohippuric acid (CPAH) and phosphate (Tp/CIn) for staging renal function were carried out. The results of this investigation show a significant inverse correlation between the glomerular function regained and the duration of intermittent dialysis.

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