Outcome of acute renal failure in children in Chennai, India

Abstract

Background: Acute Renal Failure (ARF) is one of the common causes of morbidity and mortality in children. With the availability of increasing knowledge and awareness, dialysis facilities and excellent supportive treatment, the overall outcome is changing. This study is undertaken to find out the outcome of ARF in children.Methods: This prospective cross-sectional study was done in Institute of Child Health and Hospital for Children, (ICH and HC) Egmore, Chennai from February 2014 to January 2016. Children with elevated blood urea (>40 mgs/dl) and serum creatinine (>1 mg/dl) were included and evaluated for etiology, treatment modality and outcome and other co-morbid features. Data was analysed on SPSS 20.0. P value of <0.05 was considered significant.Results: A total of 105 children (65 boys, 40 girls) from newborn period to 12 years were examined. The common age of presentation of ARF is 1-4 years with a male preponderance and acute glomerulonephritis were found to be commonest cause. There was no statistically significant difference in mortality in relation to age group (P 0.98). There was a statistically significant difference in mortality in relation to duration of oliguria (P 0.02), Serum creatinine levels (P 0.03). The role of other biochemical values like serum potassium (P 0.14), serum bicarbonate (P 0.59) were not found statistically significant. Peritoneal dialysis in general improves survival, but it is not statistically significant (P 0.33). Systemic complications associated with ARF increases mortality and it is statistically significant (Chi- square value = 9.13, P = 0.003).Conclusions: ARF in children is due to transient disorders and early referral to major centres even with 1-2 days oliguria and early treatment will improve the prognosis. Peritoneal dialysis in severe ARF with associated complications really helped the children.