Renal emergencies in children.

Acute renal failure, severe hypertension, and some complications of the nephrotic syndrome and chronic renal failure are the renal emergencies most frequently seen in the pediatric age group. Diagnosis of acute renal failure is based mainly upon U/P ratios of osmolality and urea as well as a negative mannitol test. Conservative medical management is useful in uncomplicated cases, whereas dialytic procedures are more effective in severe or complicated cases. The most frequent reversible complications in chronic renal failure are infections, extracellular volume changes, electrolyte imbalance and cardiovascular alterations. Intercurrent infection and vein thromboses are the most frequent complication in minimal change nephrotic syndrome and they may be a cause of death. Early diagnosis and adequate treatment are mandatory in these complications.