Aetiology and outcome of acute and chronic renal failure in infants.
BACKGROUND
The aetiology and outcome of acute (ARF) and chronic renal failure (CRF) in infants were analysed in a retrospective study.


METHODS
Between January 1997 and April 2004 all children <1 year of age with a serum creatinine >100 mumol/l at Hannover Medical School were followed up for up to 6 years. One hundred and nineteen children with a serum creatinine >100 mumol/l were identified, 70 infants suffering from ARF and 49 from chronic kidney disease (CKD), stages 3-5.


RESULTS
Renal failure was caused in 49/119 (41%) by congenital and in 70/119 (59%) by acquired diseases. The aetiology of ARF (n = 70) included cardiac (27%), prematurity (27%), septic (10%), hepatic (9%), renal (9%) and other (18%) causes. Twelve infants needed transient dialysis treatment. Renal function recovered in all surviving children. The mortality rate was 37%. Causes of death were unrelated to kidney function. Twenty-one of 49 infants with CKD were dialyzed with a median age of 65 days at the start of dialysis, and 23/49 children received a kidney transplant (RTx). The 5-year patient and graft survival for RTx-children of 95.5% was not different from older children. The 5-year patient survival rate of 26 children with CKD without RTx was 63%. The causes of death were parental refusal of therapy in neonates (n = 4) and life-threatening extra-renal comorbidity (n = 3).


CONCLUSIONS
Renal replacement therapy offers good chances of survival in infants without life-threatening comorbidity. Patient survival of infants treated for CKD in the first year of life was comparable to that of older children.
Wedekin
Mirja
M
Department of Pediatric Nephrology, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany.
Ehrich
Jochen H H
JH
Offner
Gisela
G
Pape
Lars
L
D058186:Acute Kidney Injury / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000002:abnormalities; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D011247:Pregnancy; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal