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2017 ; 9
(5
): e1274
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gab.com Text
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A Retrospective Study of Acute Renal Failure in Children: Its Incidence,
Etiology, Complications and Prognosis
#MMPMID28652957
Ismail Hassan K
; Hodan M J
; Li C
Cureus
2017[May]; 9
(5
): e1274
PMID28652957
show ga
BACKGROUND: Acute renal failure (ARF) developed due to various causes and may
lead to significant morbidity and mortality among pediatric patients. OBJECTIVES:
The study was conducted to determine the incidence, etiology, outcome of
treatment and clinical presentation of ARF in pediatric patients in Somalia.
METHODS: Comprehensive case history of 39 pediatric patients below 12 years of
age, admitted with renal diseases in four tertiary care hospitals in Hargeisa and
Borama cities in Somalia during December 2015 to November 2016. They were
subjected to clinical investigation and laboratory test analysis based on the
inclusion criteria of renal insufficiency characterized by serum creatinine level
more than 1.5 mg/dl. RESULTS: ARF was most commonly found in five to 12 years age
group (53.8%) compared to infant (zero to one year) and pre-school (one to five
years) children (23.08%). Mean age of presentation was 6.14 years. Male female
ratio in this study was 1.2: 1. Most common presenting clinical feature in our
study was oliguria (97.43%), swelling (69.2%), fever (84.1%), abdomen pain and
nausea-vomiting (41.02%). Common clinical signs were edema (66.66%), altered
sensorium (51.28%), hematuria (48.71%) and hypertension (38.46%). Snake bite and
acute post streptococcal glomerulonephritis were the two most common causes of
ARF in children in our study. Common complications were hypertension (38.46%),
anemia (35.89%), hyperkalemia (25.64%) and infection (20.51%), all of which were
within the previously reported range. The factors which correlated positively
with increased mortality and morbidity were females with age below one year ,
etiology like septicemia and systemic lupus erythematosus (SLE), high peak serum
creatinine concentration and complicated by disseminated intravascular
coagulation (DIC). CONCLUSION: Many causes of ARF are preventable and it should
be possible to reduce mortality and morbidity due to ARF through purposive
preventive measure and availability of the better medical facility.