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Chapter-15 Acute Renal Failure

BOOK TITLE: Principles of Pediatric & Neonatal Emergencies

Author
1. Bagga Arvind
2. Mantan Mukta
ISBN
9788184489507
DOI
10.5005/jp/books/11182_15
Edition
3/e
Publishing Year
2011
Pages
11
Author Affiliations
1. All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India, All India Institute of Medical Sciences, New Delhi, India, AIIMS, New Delhi, India, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Email: arvindbagga@hotmail.com, All India Institute of Medical Sciences, New Delhi India, All India Institute of Medical Sciences, New Delhi, e-mail: arvindbagga@hotmail.com, All India Institute of Medical Sciences, New Delhi
2. Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India, AIIMS, New Delhi, India, All India Institute of Medical Sciences, New Delhi, India, All India Institute of Medical Sciences, New Delhi, e-mail:muktamantan@hotmail.com, Maulana Azad Medical College, New Delhi, India, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India, Maulana Azad Medical College University of Delhi, New Delhi, India, Maulana Azad Medical College and Associated Hospitals, New Delhi, India
Chapter keywords

Abstract

Acute renal failure (ARF) is an important emergency where prompt and appropriate management is life saving, whereas injudicious treatment may result in life-threatening complications. ARF is characterized by a rapid deterioration of normal renal function resulting in retention of nitrogenous wastes and other fluid and electrolyte derangements, which are usually felt to be reversible. Oliguria (urine volume < 0.5 ml/kg/h) is a prominent feature. In a small proportion of patients, the urine output may be normal or only slightly reduced (non-oliguric renal failure); elevated blood levels of urea, creatinine suggest the diagnosis in such cases. ARF usually occurs in patients with previously normal renal function but may occasionally be superimposed on pre-existing renal disease (acute-on-chronic renal failure). The incidence of ARF in neonatal and pediatric units varies between 1-25%, depending upon criteria used for its definition. Despite advances in therapy the mortality due to the condition is still high (30-40%) and a proportion of patients may progress to chronic kidney disease and dialysis dependency.

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