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Pediatric Nephrology

, Volume 18, Issue 12, pp 1289–1292 | Cite as

Acute renal failure in children with idiopathic nephrotic syndrome

  • Nagamani Agarwal
  • Kishore D. PhadkeEmail author
  • Isha Garg
  • Priya Alexander
Brief Report

Abstract

Acute renal failure (ARF) is an uncommon but alarming complication of idiopathic nephrotic syndrome. The renal failure could be secondary to causes evident from the history and evaluation, such as severe intravascular volume depletion, acute tubular necrosis, allergic interstitial nephritis, bilateral renal vein thrombosis, acute pyelonephritis, or rapid progression of the original glomerular disease. It may be termed idiopathic if the underlying cause is undetermined. We present three children with idiopathic nephrotic syndrome who were admitted with acute renal failure. One case was due to drug-induced allergic interstitial nephritis. The other two were idiopathic in nature. Improvement in renal function occurred in the three patients over a variable period of 10 days to 4 weeks. After careful exclusion of well-known causes of acute renal failure, idiopathic acute renal failure (IARF) should be considered as a diagnostic possibility in these patients. The exact pathophysiology of IARF is not understood. Possible proposed explanations include interstitial edema, tubular obstruction, altered glomerular permeability, and unrecognized hypovolemia.

Keywords

Idiopathic nephrotic syndrome Acute interstitial nephritis Interstitial edema Acute renal failure Idiopathic acute renal failure 

Notes

Acknowledgement

The authors would like to acknowledge the help of Dr. Jyoti Sharma in the preparation of the revised manuscript.

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Copyright information

© IPNA 2003

Authors and Affiliations

  • Nagamani Agarwal
    • 1
  • Kishore D. Phadke
    • 1
    Email author
  • Isha Garg
    • 2
  • Priya Alexander
    • 2
  1. 1.Department of Pediatrics, Children’s Kidney Care CenterSt. Johns Medical College and HospitalIndia
  2. 2.Department of PathologySt. Johns Medical College and HospitalBangaloreIndia

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