Acute renal failure in neonates

Acute renal failure [ARF] is a common problem in admitted neonates in intensive care units. In most patients ARF accompanies with a predisposing factor such as sepsis, heart failure, perinatal asphyxia or prematurity. This study was to determine the causes and outcome of ARF in hospitalized newborn. In a descriptive cross sectional study we evaluated neonates with ARF who had been hospitalized in Children welfare teaching Hospital from July 2009 to july2010. There were 50 cases diagnosed as ARF in 2500 hospitalized neonates [2%].The male to female ratio in patients with ARF was 3.16:1. Most of involved patients were term 35[70%]. The prevalence of renal, pre renal and post renal causes of ARF was 29 [58%], 15[30%] and 6[12%] respectively. The most common predisposing factors for ARF in our study was sepsis 28[56%], genitorenal anomalies 15[30%], perinatal asphyxia 3[6%], drug toxicity in 3[6%]. One patient [2%] had respiratory distress syndrome. Among admitted neonates with ARF 6[12%] died and it was significantly higher in patients with sepsis [P<0.05]. ARF is a common emergency entity, physicians play a critical role in recognizing early ARF, preventing iatrogenic injury, and reversing the course of ARF

Chronic renal failure in children admitted to children welfare teaching hospital

Chroic renal failure [CRF] is a devastating medical, psychological, social and economic problem for patients and their families. The aim of the present study was to determine the etiology, clinical presentations and highlight treatment modalities used for patients with CRF admitted to children welfare teaching hospital. A Retrospective study of all children with CRF admitted to children welfare teaching hospital during the period from 1[st] of jan.2002 to 1[st] of jan.2007 were included in the study .CRF was defined as having glomerular filtration rate less than 80ml /min/1.73m2. The study group included 50 patients with CRF below 17 years of age, 29[58%] males and 21[42%] females. Male: female ratio 1.38:1. Their age ranged between [1m -17 year].Twenty [40%] patients were above 10 years of age. In this study the mean glomerular Filtration rate was [29.5 + 18.5ml /min/1.73m2]. Congenital abnormalities were the major cause of CRF, it was found in 18 patients [36%], followed by hereditary conditions in 14 [28%] patients and glomerular diseases in 13 [26%] patients. The most common presenting symptom was anemia. It was found in 16[32%] patients followed by hypertension in 12 patients [24%] and failure to thrive in 12[24%] patients. Twenty-one patients [42%] received peritoneal dialysis, four [8%] received hemodialysis. Renal transplant was done to 3 patients [6%]. Congenital abnormalities was to the most common cause of CRF in our patients. Establishing registry system that provide detailed information concerning the incidence, causes, and overall outcomes of mild to severe renal functional impairment acquired during developmental age can clarify further the natural history of the disease and the factors that influence its course