Skip to main content

Advertisement

Log in

Factors associated with mortality in acute renal failure (ARF) in children

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Objective: To assess the factors that affect the mortality in acute renal failure (ARF) in children. Patients and methods: We studied 149 patients with ARF and described the findings by age, gender, pathophysiological mechanism of renal damage, and type of renal damage, which can be oligoanuric and/or septic. We used multiple logistic analysis, Cox analysis for survival, and Kaplan–Meier curves. Results: The male/female ratio was 91/58. The most affected age groups were newborns (44.3%) and infants (37.6%). The ARF mechanism was ischemic in 87 cases (58%) and the most frequent clinical type was nonoliguric in 118 cases (79.2%). In the multiple logistic regression analysis, only oliguria (P=0.07) and age group (P=0.049) were associated with mortality. In the survival analysis using the Cox method, oliguria (P=0.003) and sepsis (P=0.03) were associated with mortality. The survival curves showed that the cumulative probability of dying in the first 10, 20, or 40 days after the event was 75, 70, and 45% respectively. When oliguria was present, the survival at day 10 was 47% and when sepsis was present it was 68%. Conclusion: Oliguria, age, and sepsis are factors associated with mortality in children with ARF.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Hentschel R, Lodige B, Bulla M (1996). Renal insufficiency in the neonatal period. Clin Nephrol 46:54–58

    CAS  PubMed  Google Scholar 

  2. Sakarcan A, Karabocuoglu M (1995). Renal replacement therapies for critically ill pediatric patients. Turk J Pediatr 37: 7–13

    CAS  PubMed  Google Scholar 

  3. Arora P, Kher V, Rai KP, Singhai KM, Gulati S, Gupta A (1997). Prognosis of acute renal failure in children: a multivariate analysis. Pediatr Nephrol 11:153–155

    Article  CAS  PubMed  Google Scholar 

  4. Conlon PJ, Jefferies F, Krigman HR, Corey GR, Sexton DJ, Abramson MA (1998). Predictors of prognosis and risk of acute renal failure in bacterial endocarditis. Clin Nephrol 49:96–101

    CAS  PubMed  Google Scholar 

  5. Wong W, McCall E, Anderson B, Segedin E, Morris M (1996). Acute renal failure in the paediatric intensive care unit. NZ Med J 109:459–461

    CAS  Google Scholar 

  6. Conlon PJ, Procop GW, Fowler V, Eloubeidi MA, Smith SR, Sexton DJ (1996). Predictors of prognosis and risk of acute renal failure in patients with Rocky Mountain spotted fever. Am J Med 101:621–626

    Article  CAS  PubMed  Google Scholar 

  7. Smoyer WE, McAdams C, Kaplan BS, Sherbotie JR (1995). Determinants of survival in pediatric continuous hemofiltration. J Am Soc Nephrol 6:1401–1409

    CAS  PubMed  Google Scholar 

  8. Airede A, Bello M, Weerasinghe HD (1997). Acute renal failure in the newborn: incidence and outcome. J Paediatr Child Health 33:246–249

    Article  CAS  PubMed  Google Scholar 

  9. Verlato G, Fanos V, Tato L, De Marco R (1997) Mortality from renal causes of death in an Italian population under 20 years of age in the 1979–1991 period. Pediatr Med Chir 19:365–368

    CAS  PubMed  Google Scholar 

  10. Flores NG, Joachin RH, Lopez PMG, Corzo PJA, Ramirez GLA (1998). Perinatal risk factors for mortality in the high-risk newborn. Gynecol Obstet Med 66:440–443

    Google Scholar 

  11. Lombardi R, Zampedri L, Rodriguez I, Alegre S, Ursu M, Di Fabio M (1998).Prognosis in acute renal failure of septic origin: a multivariate analysis. Ren Fail 20:725–732

    Article  CAS  PubMed  Google Scholar 

  12. Kanwal KK (1992), Evaluation of renal functions. In: Manual of pediatric nephrology, chap 1, pp 2–22

  13. Spizzirri FD, Rahman RC, Bibiloni N, Ruscasso JD, Amoreo OR (1997).Childhood hemolytic uremic syndrome in Argentina: long term follow-up and prognostic features. Pediatr Nephrol 11:156–160

    Article  CAS  PubMed  Google Scholar 

  14. Florentín de Merech L (2001). Prevalencia de insuficiencia renal aguda y de sus etiologías más frecuentes en pacientes nefrológicos pediátricos. Arch Argent Pediatr 99:219–227

    Google Scholar 

  15. Jmelnitsky LB, Sasbon J, Weller G (1995). Insuficiencia renal aguda en el postoperatorio cardiovascular inmediato con circulación extracorpórea. Arch Argent Pediatr 93:372–375

    Google Scholar 

  16. Liano F, Pascual J (1996). Epidemiology of acute renal failure: a prospective multicenter, community-based study. Madrid Acute Renal Failure Study Group. Kidney Int 1996 50:811–818

    CAS  Google Scholar 

  17. Jensen MB, Ejlersen E, Eliasen KR, Lokkegaard H (1995). Prognosis for patients admitted to intensive care units with acute renal failure requiring dialysis. Ugeskr Laeger 1 157:2564–2569

    CAS  Google Scholar 

  18. A national study of risk factors associated with mortality in very low birth weight study group. J Paediatr Child Health (1997) 33:18–25

    Google Scholar 

  19. Flynn JT (1998). Causes, management approaches, and outcome of acute renal failure in children. Curr Opin Pediatr 10:184–189

    Article  CAS  PubMed  Google Scholar 

  20. Vega J, Borja H, Videla C, Aldunate T, Clavero R, Echevarria C, Torres H, Varela C, Vilches G, Diaz R (1996). Acute kidney failure in patients with and without sepsis: prognosis and clinical course. Rev Med Chil 124:938–946

    CAS  PubMed  Google Scholar 

  21. Rivera-Moreno MA, Mercado-Arellano JA, Ulloa-Ricardez A, Franco-Gutierrez M (1999). Risk factors related to mortality in newborns with stage III necrosing enterocolitis. Gac Med Mex 135:245–251

    CAS  PubMed  Google Scholar 

  22. Fiaccadori E, Lombardi M, Leonardi S, Rotelli CF, Tortorella G, Borghetti A (1999). Prevalence and clinical outcome associated with preexisting malnutrition in acute renal failure: a prospective cohort study. J Am Soc Nephrol 10:581–593

    CAS  PubMed  Google Scholar 

Download references

Acknowledgment

We thank the University Support Laboratory at the Nephrology Unit, Universidad Peruana Cayetano Heredia.

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Reyner Loza or César Loza.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Loza, R., Estremadoyro, L., Loza, C. et al. Factors associated with mortality in acute renal failure (ARF) in children. Pediatr Nephrol 21, 106–109 (2006). https://doi.org/10.1007/s00467-005-2038-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-005-2038-y

Keywords

Navigation