title: Prognosis of acute renal failure in children.
abstract: Acute renal failure (ARF) is the acute loss of renal function over a period of hours or days. Given the poor prognosis of ARF among children, there is some urgency to identifying more effective prognostic indicators for detecting disease onset. Such indicators would help provide the means of selecting patients who would benefit the most from early aggressive treatment. In this study we assessed the etiologic and prognostic indicators of ARF, including several risk factors such as sepsis, respiratory distress, age, among others, in 300 children who were admitted to the Ali Asghar Children's Hospital, Tehran, Iran, from 1990 to 2003. Statistical analysis was performed using multiple regression and chi-square methods, and a score to determine the prognosis of ARF in children was developed.
  
  
  RESULTS
  Based on the results of this study the three common causes of ARF are acute tubular necrosis (ATN, 38%), acute glumerulonephritis (24%) and hemolytic uremic syndrome (24.1%). The overall mortality rate among our patients was 24.7%, with the highest risk group being those patients suffering from ischemic ATN. In addition, the correlation (p<0.0005) between the etiology and mortality rate was particularly high in patients with ischemic ATN. Mortality was also high (68%) in children younger than 2 years. Multiple regression models revealed that among those factors that significantly differed between the survivors and nonsurvivors, only the necessity of dialysis (p<0.0005), the use of mechanical ventilation (p=0.05) and disseminated intravascular coagulation (p=0.038) can be regarded as independent determinants of ARF prognosis in children.
authors.affiliation: Ali Asghar Children's Hospital, Tehran, Iran. hasanotukesh@yahoo.com
authors.forename: Hasan
authors.initials: H
authors.lastname: Otukesh
authors.forename: Rozita
authors.initials: R
authors.lastname: Hoseini
authors.forename: Nakissa
authors.initials: N
authors.lastname: Hooman
authors.forename: Majid
authors.initials: M
authors.lastname: Chalian
authors.forename: Hamid
authors.initials: H
authors.lastname: Chalian
authors.forename: Ali
authors.initials: A
authors.lastname: Tabarroki
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000401:mortality; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies