[Diagnosis of acute renal failure in pediatric nephrology].

Acute renal insufficiency (ARI) complicated the course of the underlying process, including primary and secondary glomerulonephritis, interstitial nephritis, pyelonephritis, dysmetabolic nephropathies, urolithiasis, tubulopathies, renal congenitae defects and injuries in 136 of 1695 children with nephrological diseases hospitalized at Republican Pediatric Renal Center during the last decade. In 69.1% cases ARI developed by the renal type, in 23.5% cases was caused by prerenal factors, and rarely (in 7.4% cases) by postrenal factors. Renal ARI in children was caused by 5 causes, including glomerulonephritis (47%), acute tubular necrosis (19%), interstitial nephritis (14%), vascular disorders (11%) resultant from vasculitis, renal vein thrombosis, and acute crystalluria (9%) which developed in the presence of grave dysmetabolic nephropathy. Among three clinical variants of ARI the most severe was observed in renal ARI leading to grave endogenous intoxication and pronounced decompensation of renal function. More benign course of renal ARI caused by acute tubular necrosis or acute crystalluria differed significantly from prerenal ARI by a more pronounced endogenous intoxication, increased fractionated sodium excretion, and renal insufficiency index higher than 1.