[Physiopathology, diagnosis and treatment of acute renal insufficiency]. 1991

G Gordillo-Paniagua, and O Hernández-Rodríguez
División de Postgrado, Universidad de la Salle, México, D.F.

Fifty-two clinical charts of children who had been discharged from this hospital, after being treated for acute renal failure, were analyzed to determine the incidence, presentation and results of the treatment used. We found that 0.7% of the total number of children admitted developed this complication and that 4/5 of them were under two years old. The initial illnesses were gastroenteritis, bronchial pneumonia, cyanogenic cardiopathies and sepsis. Some of the patients had hypoxic episodes or went into hypovolemic shock or a combination of both. In half of the patients diagnosis was reached from anamnesis, from of oliguria, acidosis and nitrogen retention. In the rest from whom a urine sample was obtained, the diagnosis was confirmed when the FeNa was higher than 2 and because the U/P osmolarity and urea were under 1.3 and 5 respectively. The oliguric type of acute renal failure was seen in 65% of the cases; the non-oliguric type in 35%. In the first group the mortality rate reached 6.5% even though a third of them were placed under dialysis. Yet, in another 7 cases, dialysis could not be used because the child was in shock. Of the 18 cases of non-oliguric acute renal failure, 12 recovered; only 3 required dialysis. We conclude that the high mortality rate in cases of acute renal failure depends on the severity of the underlying illness, the age of the patient and the delay in the diagnosis of the disease. The use of dopamine and furosemide, as well as the application of hemoperfusion instead place of peritoneal dialysis in neonates with sepsis, could improve results.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008800 Mexico A country in NORTH AMERICA, bordering the Caribbean Sea and the Gulf of Mexico, between BELIZE and the UNITED STATES, and bordering the North Pacific Ocean, between Guatemala and the UNITED STATES.
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003131 Combined Modality Therapy The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used. Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D004232 Diuretics Agents that promote the excretion of urine through their effects on kidney function. Diuretic,Diuretic Effect,Diuretic Effects,Effect, Diuretic,Effects, Diuretic
D006435 Renal Dialysis Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION. Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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