Renal failure in childhood.

Renal failure in infants and children requires prompt and thorough diagnostic evaluation for reversible causes and careful medical management. Congenital malformations of the renal parenchyma and urinary drainage system must be excluded in any child, even the adolescent. The management of these patients requires close cooperation with the (pediatric) urologist. These children are at highest risk for the development of complications, such as growth failure, osteodystrophy, and urinary tract infections. Prolonged progressive renal insufficiency in this group must be anticipated. In contrast, acquired renal insults may result in acute, reversible renal failure. Awareness of the hemodynamic or nephrotoxic insults that can result in ARF, and appropriate diagnostic and therapeutic maneuvers, may minimize morbidity and mortality. CRF presents the physician with long-term and complex challenge of medical management. Dietary and drug therapy can be remarkably effective in reducing the complications of CRF. Rehabilitation with successful renal transplantation is an attainable goal for most uremic children.