Wong W, McCall E, Anderson B, Segedin E, Morris M
Paediatric Renal Unit, Starship Children's Hospital, Auckland.
N Z Med J. 1996 Dec 13;109(1035):459-61.
To review a group of children with acute renal failure (ARF) requiring renal replacement therapy in a paediatric intensive care unit (PICU).
Case records of children admitted to paediatric intensive care unit between January 1992 and July 1995 were reviewed for demography, diagnosis, modality of treatment, duration, complications of therapy and renal outcome. Long term follow up was sought from patients' referring paediatricians.
Twenty children with a mean age of 2 years and 3 months required acute renal replacement therapy. The most common cause was diarrhoea associated haemolytic uraemic syndrome with a mean duration of dialysis of 11.5 (SD 3.1) days (range 5-15. Four children had septicaemic illnesses; three with multiorgan system failure, one of whom died. Peritoneal dialysis was the only modality in 16 patients and four children were treated with continuous venovenous haemofiltration. Eight of the 20 patients were discharged from the paediatric intensive care unit with normal renal function as judged by serum creatinine. Long-term follow up showed normalisation of serum creatinine in a further eight of ten patients.
The most common cause of acute renal failure was diarrhoea associated haemolytic uraemic syndrome with an excellent outcome (100% patient survival). Children who had acute renal failure due to other illnesses had a higher mortality (27%).
回顾一组在儿科重症监护病房（PICU）需要肾脏替代治疗的急性肾衰竭（ARF）患儿。
回顾1992年1月至1995年7月入住儿科重症监护病房患儿的病例记录，内容包括人口统计学资料、诊断、治疗方式、持续时间、治疗并发症及肾脏转归。向患儿的转诊儿科医生寻求长期随访情况。
20名平均年龄为2岁3个月的患儿需要急性肾脏替代治疗。最常见的病因是腹泻相关的溶血尿毒综合征，平均透析时间为11.5（标准差3.1）天（范围5 - 15天）。4名患儿患有败血症；3名有多器官系统功能衰竭，其中1名死亡。16例患者仅采用腹膜透析，4例患儿采用连续性静脉 - 静脉血液滤过治疗。20例患者中有8例从儿科重症监护病房出院时肾功能正常，根据血清肌酐判断。长期随访显示，另外10例患者中有8例血清肌酐恢复正常。
急性肾衰竭最常见的病因是腹泻相关的溶血尿毒综合征，预后良好（患者生存率100%）。因其他疾病导致急性肾衰竭的患儿死亡率较高（27%）。
