ACUTE-RENAL-FAILURE IN PEDIATRIC-PATIENTS - A RETROSPECTIVE STUDY OF 89 CASES

Between 1982 and 1992, 89 patients aged six months to 15 years were tr eated for acute renal failure at the Ibn Rochd Teaching Hospital. Ther e were 51 males (57 %) and 38 females (43 %). All patients received co nservative treatment. Fifty-eight patients (65 %) required dialysis at the acute phase. The dialysis technique used was peritoneal dialysis in 22 cases (25 %) and hemodialysis in 36 (40 %). Twenty-nine patients received emergency dialysis for severe sodium and water overload and/ or severe hyperkalemia. In the other cases, dialysis was initiated bec ause of high blood urea and creatinine levels ; before dialysis, blood urea exceeded 33 mmol/l (2 g/l) in every case and mean urea level was 51 mmol/l. Causes of acute renal failure included glomerulonephritis (n = 46), hemolytic uremic syndrome (n = 12), acute interstitial nephr itis (n = 9), urinary tract obstruction (n = 5), and renal hypoperfusi on (n = 11) ; in six cases, no cause was identified. Mortality rate wa s 17 %. Recovery rate was higher in the subgroup of patients without a nuria. Outcome was favorable in 65.5 % of patients with glomerular dis ease. Most patients in this study did not require intensive care and n one had post-cardiac surgery or neonatal acute renal failure which are known to carry a poor prognosis.