Clinicial Observations of Oliguric Acute Renal Failure in Children

Lee, Sung Soo; Choi, Young Mi; Bae, Chong Woo; Cha, Sung Ho; Cho, Byoung Soo

Abstract

PURPOSES: We studied the clinicial findings of oliguric acute renal failure(ARF) developed on admission or during treatment of other diseases.
METHODS
We performed a retrospective analysis of medical records of 118 patients with oliguric ARF who had been admitted to Kyunghee University Hospital since January 1988 to December 1997. Diagnostic criteria of oliguric ARF are serum creatinine>1.0mg/dl and urine output<400ml/ m2/day(in neonate : serum creatinine>1.5mg/dl and urine output<1.0ml/kg/hr).
RESULTS
In 118 cases, male : female ratio is 1.3 : 1, age distribution was neonate 54 cases(45.8 %), infant 13 cases(11.0%), 2-4 years 19 cases(16.1%), 5-15 years 32 cases(27.1%), most cases were neonates. Prerenal ARF was 81 cases(68.6%), renal ARF 36 cases(30.5%), postrenal ARF 1 case(0.9%). Prerenal ARF was more common than renal ARF in younger age, renal ARF increased with increasing age. Most common etiologies were prematurity in neonate, sepsis in infant, acute gastroenteritis in 2-4 years, primary renal diasease in 5-15 years. Cases in the intensive care unit were 52 cases(44.0%), 42 out of these cases were neonate. Primary diseases inducing ARF were more fatal in neonates. Mortality rate was 62.9% in neonate, 38.5% in infant, 15.8% in 2-4 years, and 15.6% in 5-15 years. Dialysis treatment was performed in 15 cases (12.7%), all 3 cases of neonates died, 1 out of 12 of the remaining cases(8.3%) died. The mortality rate was less than that of the supportive care mortality of 23.1%.
CONCLUSION
Oliguric ARF developed most commonly in neonate. It was related to increased survival of premature neonate. Renal ARF increased with age. Prognosis is dependent on primary diseases inducing ARF and treatment methods. Early detection and aggressive treatment such as dialysis is needed to lower mortality and make good prognosis in oliguric ARF patients.