RESUMEN
This work aims to evaluate the role of renal biopsy in the diagnosis of patients presented with acute renal failure [ARE] with correlation between the clinical and pathological diagnosis and their impaction on the prognosis. The study was preformed on fifty patients presenting with the manifestation of ARE received in Pediatric Hospital Mansoura Eaculty of Medicine. Paraffin blocks were cut for hematoxyline and eosin and special stains as well. Analysis of pathological findings with clinical parameters related to outcome of patients. This study delineated that the childhood cause of ARF are acute glomerulonephritis [48%] followed by acute tubular necrosis [18%] then thrombotic microangiopathy [12%], then malignant lymphomatous infiltration [6%], then acute pyelonephritis [4%] lastly renal cortical necrosis [2%] and interstitial hemorrhage [2%]. The renal biopsy confirmed the clinical diagnosis in 58% of cases and altered .the clinical diagnosis in 12% of cases. Moreover in cases with uncertain clinical diagnosis the renal biopsy clarified the accurate diagnosis. More over the biopsy guided the treatment in some cases. The results of this study demonstrate that renal biopsy is essential in many cases of pediatric ARF not only to confirm the diagnosis but also to diagnose cases of unknown causes and changes the clinicat diagnosis in many cases as well