The Evaluation of Children with Acute Renal Failure in Pediatric Intensive Care Unit

Purpose: To assess the profile, clinical outcome and factors affecting prognosis of children with acute renal failure (ARE) admitted to pediatric intensive care unit (PICU). Material and Methods: Twenty-two children with ARE were included. Demographics, diagnoses, clinical and laboratory findings and pediatric risk of mortality score of all patients were documented. Results: The patient group consisted of 11 boys and 11 girls. The mean age and average length of PICU were 24 month (range 2-180 months) and 4 days (range 1-25 days), respectively. The etiologies of ARF cases were sepsis (n=6), dehydratation (n=6), congenital heart disease (n=3), tubulointersitital nephritis (n=2), and primary renal diseases (n=2). During the follow-up period, ten patients died. The PRISM III score, length of PICU days, the rate of ventilator treatment, exposure nephrotoxic drugs, the level of transaminases in nonsurvivor patients were significantly higher than survivor paticnts. Mean blood pressure and blood urea nitrogen in nonsurvivor patients were significantly lower than survivor patients. Conclusion: This study shows that patients with ARF in PICU have very high mortality. Renal functions should be followed in patients with sepsis, congenital heart disease, hepatic dysfunction, and malignancy in the light of renal failure. Nephrotoxic drugs should be avoided if not essential. 500 PRISM III score could be used to estimate mortality in patients with ARE in PICU.