Abstract

BackgroundAcute renal failure (ARF) developed due to various causes and may lead to significant morbidity and mortality among pediatric patients.ObjectivesThe study was conducted to determine the incidence, etiology, outcome of treatment and clinical presentation of ARF in pediatric patients in Somalia.MethodsComprehensive 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.ResultsARF 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).ConclusionMany 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.

Highlights

  • Acute renal problems constitute a large proportion of hospital admission and outpatient attendance among pediatric population

  • 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

  • The emphasis on presentation remains cardinal, but early detection and appropriate treatment can provide complete recovery in a large proportion of Acute renal failure (ARF) in children, which is the major goal of ARF therapy

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Summary

Introduction

Acute renal problems constitute a large proportion of hospital admission and outpatient attendance among pediatric population. Acute renal failure (ARF) in children, compared with adults, are often reported with speedy recovery without any residual effect and complications. ARF may often lead to life-threatening conditions and it is regarded as one of the major cause of significant morbidity and mortality among pediatric patients. Despite the major advance in the PICU tools and renal replacement therapy (RRT) methods, the reported mortality rate among inpatients ARF is 29% to 46% [3,4]. The emphasis on prevention remains cardinal but early detection and appropriate treatment could provide complete recovery which is a major goal of ARF therapy. Acute renal failure (ARF) developed due to various causes and may lead to significant morbidity and mortality among pediatric patients

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