Abstract
Introduction: Acute renal failure (ARF) is a medical emergency that does not spare children. Its interest lies in the search for etiologies and management made difficult by the poor quality of hospital technical platform in Africa. Objectives: To improve the management of ARF in children, determine its prevalence, and identify the causes and factors associated with mortality. Patients and Methods: We reviewed the records of children from one month to 17 years hospitalized between January 2016 and December 2018 in every pediatric department at the University Hospital of Brazzaville and included those whose discharge diagnosis included the item “ARF”. Study variables were age, sex, source, (para)clinical signs, stage and type of ARF, etiology and evolutionary profile. Results: Included were 18952 hospitalized children out of whose 253 had ARF 1.3%. There were 145 (57.3%) boys and 108 (42.7%) girls with an average age of 71.5 months. The mean time to consultation was 8.1 days. ARF was at failure stage in 147 cases (58.1%). It was functional in 210 cases (83.0%), out of which 95.1% resulted from severe dehydration. No extra-renal treatment was performed. Lethality was 34.4%. Hypovolemic shock (56.3%), severe sepsis (18.4%) and severe malaria (14.9%) were the main causes. Young age, provenance of the child, severe dehydration, deep coma, oligoanuria, stage of failure, hyperkalemia, absence of an extra-renal purification center were factors associated with mortality (p Conclusion: The high prevalence of ARF and its lethality requires public health actions including proper management of dehydration and malaria but also the creation of an extra-renal purification center.
Highlights
Acute renal failure (ARF) is a medical emergency that does not spare children
Patients and Methods: We reviewed the records of children from one month to 17 years hospitalized between January 2016 and December 2018 in every pediatric department at the University Hospital of Brazzaville and included those whose discharge diagnosis included the item “ARF”
Of the 18,952 children hospitalized during the reporting period, 253 were hospitalized for an ARF (1.3%)
Summary
Acute renal failure (ARF) is a medical emergency that does not spare children. Its interest lies in the search for etiologies and management made difficult by the poor quality of hospital technical platform in Africa. Provenance of the child, severe dehydration, deep coma, oligoanuria, stage of failure, hyperkalemia, absence of an extra-renal purification center were factors associated with mortality (p < 0.0002). Acute renal failure (ARF), a rapid deterioration of renal function resulting in elevated plasma creatinine and inability of the kidney to eliminate waste nitrogen metabolism and maintain the body’s electrolytic balance [1], is a medical emergency. It is reversible in most cases, but may be life-threatening [1] [2]. The diagnosis of ARF is made by biological examinations and its management depends on the causes
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