SALMONELLA GASTROENTERITIS AND ACUTE-RENA L-FAILURE

The high incidence of acute renal failure (ARF) secondary to acute gas troenteritis remains an unresolved problem in our community. In order to work out this incidence and analyse the characteristics of the affe cted population, we studied in a health area with 550,000 inhabitants the number of cases of acute gastroenteritis that required medical car e in our hospital and how many developed ARF during 1992. We defined A RF as creatinine levels higher than 2 mg/dl. Forty two patients were a dmitted with acute gastroenteritis and stool cultures positive for sal monella enteritidis. On admission we registered clinical data (paying special attention to the hydratation state) and measurements from seru m and urine specimens (renal function, electrolytes and sediment) on a dmission and on discharge. From the total, seven patients (16.6 %) dev eloped ARF, mean age higher than the group without ARF. Mean creatinin e values on admission were 5.7 +/- 3.2. Average duration of ARF was 7. 9 +/- 3.5 days with a mean period of hospitalization of 10 +/- 4.5 day s. Although there were three patients with high creatinine kinase leve ls, the main cause of ARF was depletion of water and electrolytes. We registered an incidence of ARF secondary to salmonella of 9 % of the t otal number of ARF that required medical care in our health area durin g 1992. That is a very high rate for a country of our sociosanitary de velopment and could be easily prevented early replacement of fluids an d electrolytes.