Causes and Treatment of Acute Renal Failure in Children
https://doi.org/10.15360/1813-9779-2007-4-70-75
Abstract
Objective: to study the causes of acute renal failure (ARF) in children and to substantiate recommendations on its treatment. Fifty-nine children with ARF were followed up in 1979 to 2004. In 90% of the patients, ARF was established to be caused by hemolytic uremic syndrome (HUS), acute intestinal infection (AII), acute glomerulonephritis, and acute intravascular hemolysis. The major cause of ARF was AII in two thirds (66.1%) of the children. In the past decade, the incidence of HUS has decreased from 55 to 40%. The authors identified the following predictors of poor ARF outcome: early age, anuria, impaired consciousness progressing to spoor and coma. A combination of these symptoms is most frequently observed in patients with HUS in which the kidneys are the major target organ and the possibilities of more than 7-day treatment for anuria without dialysis are limited. In other etiology of ARF, water deprivation, antihypertensive therapy, and exchange plasmapheresis allow patients to survive until renal function restores without renal replacement therapy, by preventing serious complications.
About the Authors
O. I. Andriyanova
Branch of the Research Institute of General Reanimatology, Russian Academy of Medical Sciences, Department of Postgraduate Training of Physicians, Novokuznetsk
F. K. Manerov
Branch of the Research Institute of General Reanimatology, Russian Academy of Medical Sciences, Department of Postgraduate Training of Physicians, Novokuznetsk
Yu. A. Churlyaev
Branch of the Research Institute of General Reanimatology, Russian Academy of Medical Sciences, Department of Postgraduate Training of Physicians, Novokuznetsk
I. G. Khamin
Branch of the Research Institute of General Reanimatology, Russian Academy of Medical Sciences, Department of Postgraduate Training of Physicians, Novokuznetsk
References
1. Moghal N. E, Brocrlebank J. T., Meadow S. R. A review of acute renal failure in children: incidence, etiology and outcome. Clin. Nephrol. 1998; 49 (2): 91—95.
2. Зверев Д. В. Гемолитико-уремический синдром у детей; эффективность перитонеального диализа. Нефрология и диализ 2000; 2 (1—2).
3. Anderson R. J., Schrier R. W. Острая почечная недостаточность. В кн.: Браунвальд Е (ред.) Внутренние болезни. 6. М. Медицина; 1995. 231—246.
4. Зверев Д. В., Музуров А. Л., Долецкий А. С. Перитонеальный диализ при острой почечной недостаточности у детей. Анестезиология и реаниматология 2002; 1: 32—35.
5. Шарипов А. М., Умарова З. С. Диагностика острой почечной недостаточности в педиатрической нефрологиии. Анестезиология и реаниматология 2001; 1: 70—72.
6. Begue R. E., Mehta D. I., Blecker U. Escherichia coli and hemolytic uremic syndrome. South. Med. J. 1998; 91: 798—804.
7. Mencha B. S., Marthnez de Azagra A., de Vicent A. A. et al. Uremic hemolytic syndrome. Analysis of 43 cases. An. Esp. Pediatr. 1999; 50(5): 467—470.
8. Smith G. C. Лечение острой почечной недостаточности. Реаниматология и интенсивная терапия 2001; 1: 11—15
9. Kellum J. A., M. Decker J. Use of dopamine in acute renal failure: A metaanalysis. Crit. Care Med. 2001; 29 (8): 1526—1531.
10. Marai I., Levi Y. Dopamine in acute renal failure. Harefuah 2001; 140 (7): 644—647, 677.
11. Andreoli S. P. The pathophsysiology of the hemolytic uremic syndrome. Curr. Opin Nephrol. Hypertens. 1999; 8 (4): 459—464.
12. Zurowska A., Gockowska Z., Czarniak P., Marczak E. Changing clinical course of hemolytic uremic syndrome in children. Pol. Merkuriusz Lek. 2000; 8 (46): 234—235.
13. Foreman J. W. Почечная недостаточность. В кн.: Полин Р. А., Дитмар М. Ф. (ред.) Секреты педиатрии. М. -СПб.; 1999. 575.
14. Kaplan B. S., Meyers K. E., Schulman S. L. The pathogenesis and treatment of Hemolytic Uremic syndrome. J.A.S.N. 1998: 1126—1132.
15. Spizzirri F. D., Rahman R. C. Childhood hemolytic uremic syndrome in Argentina — long — term follow-up and prognostic features. Pediatr. Nephrol. 1997; 11: 156—160.
16. Папаян А. В., Панков Е. А. Аспекты этиопатогенеза, лечения и прогнозирования гемолитико-уремического синдрома у детей. В кн.: 1 конгр. Педиатров-нефрологов России. СПб.; 1996. 337.
Review
For citations:
Andriyanova O.I., Manerov F.K., Churlyaev Yu.A., Khamin I.G. Causes and Treatment of Acute Renal Failure in Children. General Reanimatology. 2007;3(4):70-75. (In Russ.) https://doi.org/10.15360/1813-9779-2007-4-70-75
Views:
5363
Email this article 