Insuficiencia renal aguda en niños críticamente enfermos. Estudio preliminar
- A. Medina Villanueva
- J. López-Herce Cid
- Y. López Fernández
- M. Antón Gamero
- A. Concha Torre
- C. Rey Galán
- F. Santos Rodríguez
ISSN: 1695-4033, 1696-4608
Year of publication: 2004
Volume: 61
Issue: 6
Pages: 509-514
Type: Article
More publications in: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )
Abstract
Objective To analyze the characteristics of acute renal failure (ARF) in critically-ill children and develop a protocol for a multicenter study Methods A prospective, descriptive study was performed in four pediatric intensive care units (PICU) over 5 months. Epidemiological, clinical and laboratory data from children aged between 7 days and 16 years with ARF were analyzed. Premature neonates were excluded Results There were 16 episodes of ARF in 14 patients and 62.5% were male (mean SD age: 50 49 months). The incidence of ARF was 2.5% of PICU patients. The most frequent primary diseases were nephro-urological (50%) and heart disease (31%). The main risk factors for ARF were hypovolemia (44%) and hypotension (37%). Six patients (37.5%) developed ARF following surgery (cardiac surgery in four, kidney transplantation in one and urological surgery in one). Furosemide was used in 13 patients (as continuous perfusion in nine), inotropes in nine and renal replacement therapy in 12. Medical complications were found in 94% and some organic dysfunction was found in 81%. The length of stay in the PICU was 21 21 days. The probability of death according to the Pediatric Risk of Mortality was 14 8%. Five patients died (36% of the patients and 31.2% of ARF episodes) Conclusions The incidence of ARF in critically-ill children is low but remains a cause of high mortality and prolonged stay in the PICU. Mortality was caused not by renal failure but by multiple organ failure