Acute Renal Failure In Children

Acute renal failure(ARF)
Is the clinical syndrome in which sudden decreasing in renal function result in inability of kidney to maintain fluid and electrolyte homeostasis, 2-3% in children, 8% in neonatal ICU.

Causes
A-prerenal causes1- dehydration
2- hemorrhage
3- hypoalbunimia
4- heart failure
B- intrinsic causes , glomeruler diseases
1- post infectious GN
2- lupus GN, HSP,
3- HUS
4- acute tubuler necrosis
5- RVT

C- post renal 1- posterior urethral valve
2- uretro-pelvic junction obstruction
3- stone, neurogenic bladder
C/F
- vomiting, diarrhea 3 days prerenal
- 6 years child with recent pharangitis+edema+HT=PSGN
- critical ill child with protracted HT and HX of exposure to nephrotoxin ATN
- neonate with hydronephrosis in prenatal U/S congenital P UJ obstruction.
Physical examination
- volume status, tachycardia, dry mouth, poor peripheral circulation, prerenal cause
- peripheral edema, basal creptation, gallop rythem, suggest GN, ATN
- rash +nephritis=SLE, HSP