Dobiliene Diana, Pundziene Birute
Clinic of Children's Diseases, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania.
Medicina (Kaunas). 2005;41 Suppl 1:21-5.
The aim of the research was to determine causes of acute renal failure in children, their outcome and to define risk factors associated with mortality. 75 children with acute renal failure, who were treated at the Clinic of Children's Diseases of Kaunas University of Medicine between 1998-2003 years, were included in the study. The age range of patients was 1 month to 16 years. They were divided into two groups. Acute renal failure was diagnosed in 42 (56%) patients (the first study group) and in 33 (44%) patients acute renal failure was together with multiple organ failure (the second study group). In the first study group 69% of cases of acute renal failure were found to be due to renal diseases and in the second study group 97% were because of extrarenal diseases. Sepsis was the most frequent cause of acute renal failure in the second group (p<0.02). Dialysis was made for 28% patients. Hypertension was diagnosed more often in the first patients group (p<0.05). Hypertension persisted in 9 (36%) patients after recovery. Chronic renal failure developed in two patients. 28 (37.3%) patients of the original study group died. Mortality rate for children with multiple organ failure was higher than for the children, who had renal insufficiency only (78.8% vs 4.8%; p<0.001). Mortality rate of infants in the first study group was higher than for children of the same age in the second group (p<0.001). Mortality rate for children, who had oliguria or anuria, was higher in the second group, too (p<0.001).
该研究的目的是确定儿童急性肾衰竭的病因、预后,并明确与死亡率相关的危险因素。纳入了1998年至2003年间在考纳斯医科大学儿童疾病诊所接受治疗的75例急性肾衰竭患儿。患者年龄范围为1个月至16岁。他们被分为两组。42例(56%)患者被诊断为急性肾衰竭(第一研究组),33例(44%)患者急性肾衰竭合并多器官功能衰竭(第二研究组)。在第一研究组中,69%的急性肾衰竭病例被发现是由肾脏疾病引起的,而在第二研究组中,97%是由肾外疾病引起的。脓毒症是第二组急性肾衰竭最常见的原因(p<0.02)。28%的患者进行了透析。第一组患者高血压的诊断更为常见(p<0.05)。9例(36%)患者康复后高血压仍持续存在。两名患者发展为慢性肾衰竭。原研究组中有28例(37.3%)患者死亡。多器官功能衰竭患儿的死亡率高于仅患有肾功能不全的患儿(78.8%对4.8%;p<0.001)。第一研究组中婴儿的死亡率高于第二组中同年龄的儿童(p<0.001)。少尿或无尿患儿的死亡率在第二组中也更高(p<0.001)。