Incidence, causes and mortality rate of acute renal failure in critically ill children

Acute renal failure (ARF) is a common and life-threatining condition inpediatric intensive care unit (PICU), but there is a paucity of multicenter studiesabout incidence, causes, and outcomes of ARF in critically ill children. The aim ofthis study was to determine incidence, causes, and mortality rate of ARF in thePICU prospectively over 2 years.Three hundred critically ill patients aged between 1 month-17 years ( meanage was 60,5±61,9 months) were included to the study. The incidence of ARF inPICU was 15%. Fifty one percent of the patients developed ARF after PICUadmission, and ARF occured most often within the first week. Patients with ARFhave a longer PICU stay than patients without ARF. The most frequent causes ofARF in PICU were sepsis, cardiac surgery and nephrotoxic drugs (20%, 17,7% vs11% respectively). A total of 46% of patients had multiple organ dysfunctionsyndrome with a mortality rate of 76%. Forty-four percent of patients hadoliguria. ARF was prerenal and renal in 18% and 82% respectively. Dialysis wasperformed in 47% of patients. Mortality rate was 36% and ARF was not the causeof death in any of our patients.Despite major advances in caring for critically ill children, ARF remains afrequent and serious problem in the PICU. Information about the incidence,causes, and outcomes in critically ill children with ARF could be useful for takingpreventive measures and providing early treatment.Key words: acute renal failure, children, multiple organ dysfunction syndrome,pediatric intensive care unit