Abstract

From July 1998 to July 1999, 45 cases of acute renal failure were treated at Bir Hospital, Kathmandu. Out of which 24 were male and 21 were female. Age ranged from 11 months to 84 years with mean age being 35 years and 9 cases were below 10 years. Four cases with pre-renal azotaemia and twenty five cases of acute tubular necrosis (ATN) accounted for 64% of all cases. These were due to gastroenteritis 10, sepsis 6, post surgical 1, trauma 1 and obstretical complications 5. Multiple hornet stings were responsible for acute renal failure in 3 cases, acute urate nephropathy in 1 case and miscellaneous causes in 2 cases. Glomerulonephritis / vasculitis accounted for 17.7%, acute interstitial nephritis 4.4%, haemotytic uraemic syndrome (HUS) 6.6%, and post renal azotaemia in 6.6% of all cases. Mean serum creatinine was 8 mg/dl, mean blood urea 190 mg/dl. Eight cases were treated only conservatively, eighteen received haemodialysis, fourteen received peritoneal dialysis, three received both and two refused for dialysis. Average duration of hospital stay was 13.6 days. Out of the forty-five cases twenty-nine recovered normal renal function, ten expired, two recovered partially, two progressed to chronic renal failure and two left against medical advice. Overall mortality was 22.2%. Common causes of acute renal failure in our setting were gastroenteritis (22%) and sepsis (20%). HUS was exclusively seen in children following bacillary dysentery. Multiple hornet stings is an important cause of acute renal failure in our country.

Highlights

  • Acute renal failure (ARF) is defined as acute deterioration in renal function in a patient with no preexisting renal disease where patient's life can be saved by timely intervention

  • In contrast to developed countries where most cases of ARF are related to surgery and trauma in intensive care units,[2] ARF in developing countries are related to medical causes

  • Our present study showed medical causes to account for 77% of cases, gastroenteritis being the leading cause

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Summary

Introduction

Acute renal failure (ARF) is defined as acute deterioration in renal function in a patient with no preexisting renal disease where patient's life can be saved by timely intervention. It is associated with high morbidity and mortality.[1] Causes of acute renal failure vary in different parts of the world and sometimes within parts of the same country. Bir Hospital being a referral center for kidney disease, this study reflects the pattern of acute renal failure in our country. The purpose of this study was to delineate the various causes of acute renal failure in our setting and its outcome.

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