[Clinical analysis of 41 children's urinary calculus and acute renal failure].
OBJECTIVE
To analyze the treatment of acute renal failure caused by irrational drug use.


METHODS
Data of 41 cases of acute renal failure seen from July 2008 to June 2012 in our hospital were reviewed. Bilateral renal parenchymas diffuse echo was found enhanced by ultrasound in all cases. Calculus image was not found by X-ray. All children had medical history of using cephalosporins or others. Alkalinization of urine and antispasmodic treatment were given to all children immediately, 17 children were treated with hemodialysis and 4 children accepted intraureteral cannula placement.


RESULTS
In 24 children who accepted alkalinization of urine and antispasmodic treatment micturition could be restored within 24 hours, in 11 children micturition recovered after only one hemodialysis treatment and 2 children gradually restored micturition after hemodialysis twice, 4 children who accepted intraureteral cannula immediately restored micturition. In all children micturition recovered gradually after a week of treatment. Ultrasound examination showed that 39 children's calculus disappeared totally and renal parenchymas echo recovered to normal. The residual calculi with diameter less than 5 mm were found in 2 children, but they had no symptoms. The children received potassium sodium hydrogen citrate granules per os and were discharged from hospital. Ultrasound showed calculus disappeared totally one month later.


CONCLUSIONS
Irrational drug use can cause children urolithiasis combined with acute renal failure, while renal dysfunction can reverse by drug withdrawal and early alkalinization of urine, antispasmodic treatment, intraureteral cannula or hemodialysis when necessary, most calculus can be expelled after micturition recovered to normal.
Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Lu-Ping
LP
Li
Ying-Zhong
YZ
Fan
Qian
Q
Zhang
Sheng-Li
SL
Zhang
D058186:Acute Kidney Injury / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy*; D002443:Ceftriaxone / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007223:Infant; D007668:Kidney / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D019357:Potassium Citrate / Q000627:therapeutic use; D006435:Renal Dialysis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014545:Urinary Calculi / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy*
D004232:Diuretics; D002443:Ceftriaxone; D019357:Potassium Citrate