Outcome of acute renal failure in children in Chennai, India

Kumarasamy Kalyanasundaram, Harikrishnan Elangovan, Madhivanan Sailavasan


Background: Acute Renal Failure (ARF) is one of the common causes of morbidity and mortality in children. With the availability of increasing knowledge and awareness, dialysis facilities and excellent supportive treatment, the overall outcome is changing. This study is undertaken to find out the outcome of ARF in children.

Methods: This prospective cross-sectional study was done in Institute of Child Health and Hospital for Children, (ICH and HC) Egmore, Chennai from February 2014 to January 2016. Children with elevated blood urea (>40 mgs/dl) and serum creatinine (>1 mg/dl) were included and evaluated for etiology, treatment modality and outcome and other co-morbid features. Data was analysed on SPSS 20.0. P value of <0.05 was considered significant.

Results: A total of 105 children (65 boys, 40 girls) from newborn period to 12 years were examined. The common age of presentation of ARF is 1-4 years with a male preponderance and acute glomerulonephritis were found to be commonest cause. There was no statistically significant difference in mortality in relation to age group (P 0.98). There was a statistically significant difference in mortality in relation to duration of oliguria (P 0.02), Serum creatinine levels (P 0.03). The role of other biochemical values like serum potassium (P 0.14), serum bicarbonate (P 0.59) were not found statistically significant. Peritoneal dialysis in general improves survival, but it is not statistically significant (P 0.33). Systemic complications associated with ARF increases mortality and it is statistically significant (Chi- square value = 9.13, P = 0.003).

Conclusions: ARF in children is due to transient disorders and early referral to major centres even with 1-2 days oliguria and early treatment will improve the prognosis. Peritoneal dialysis in severe ARF with associated complications really helped the children.


ARF, Oliguria, Peritoneal dialysis

Full Text:



Gianantonio C, Vitacco M, Mendilaharzu F, Rutty A, Mendilaharzu J. The hemolytic-uremic syndrome. J Pediatr. 1964;64:478-91.

Trompeter RS, Schwartz R, Chantler C, Dillon MJ, Haycock GB, Kay R, et al. Haemolytic uraemic syndrome: an analysis of prognostic features. Arch Dis Child. 1983;58:101-5.

Arora P, Kher V, Gupta A, Kohli HS, Gulati S, Rai PK, et al. Pattern of ARF at a referral Hospital. Indian Pediatr. 1994;31(9):1047-53.

Kandoth PW, Agarwal G, Dharnidharka VR. ARF in children requiring Dialysis therapy. Indian Pediatr. 1994;31:305-9.

Lewy JE, Madrigal S, Herdson PB, Pirani CL, Metcoff J. Clinicopathological correlations in acute post streptococcal glomerulonephritis. Med 1971;50(6):453-501.

Gallego N, Gallego A, Pascual J. Prognosis of children with acute renal failure: a study of 138 cases. Nephron. 1993;64:399-404.

Shah BV, Merchatn MR, Almeida AF. Prognosis of ARF in Pediatrics. Indian Pediatr. 1985;22:361-5.

Mahakur AC, Das GC, Sahoo RN. Spectrum of ARF in children in Orissa. Indian J Nephrol. 1996;6(3):134.

Niaudet P, Ibrahim MH, Gagnadoux MF. Outcome of children with ARF. In Kidney Int. 1985;28(17):S148-51.

James CM, Chan MD. Peritoneal dialysis for renal failure in childhood. Clin Pediatr. 1978;17(4):349-54.

Don BR, Schambalan M. Hyperkalemia in acute glomerulonephritis, due to transient hyporeneneinic hypoaldosteronisrn. Kidney Int. 1990;38(1):1159-63.

Pereira BJ, Narang A, Pereira S. Acute renal failure in infants in the tropics. Nephrol. 1989;4(6):535-8.

Rizvi, Viswanathan. Acute renal failure in acute Gastroenteritis: our experience in a recent epidemic, Indian J Nephrol. 1991;1(4).

Saubhik S, Singhal M, Arora P. ARF following surgery. Indian Nephrol, 1996;6(3):124.