Acute renal failure in children and newborns: pathophysiology, clinical patterns and therapeutic approach

Abstract

Acute renal failure (ARF) in newborn infants and young children continues to be an important factor contributing to morbidity and mortality of critically ill and injured pediatric patients. ARF is a clinical syndrome of multifactorial origin with numerous variables influencing its evolution and resolution. While the overall mortality rate of ARF is less in children than in adults, ARF in premature newborn infants and in infants and children with congenital cardiac disease continues to have a poor prognosis [1, 2]. An appreciation of the pathophysiologic mechanisms having a role in the initiation and progression of ARF in the pediatric age group may assist the clinician with the early recognition and treatment of ARF in children. In this chapter we will review the clinical presentation, pathophysiology, and an approach to treatment and prevention of ARF in infants and children.