Moghal N E, Brocklebank J T, Meadow S R
Department of Nephrology, Birmingham Children's Hospital NHS Trust, UK.
Clin Nephrol. 1998 Feb;49(2):91-5.
We reviewed our experience of children with acute renal failure. St James's University Hospital, Leeds, UK is a tertiary referral center that serves a relatively stable regional population (former Yorkshire region). It is a mixed rural and urban population providing a unique profile of the nature of the cases and workload experienced. The data is expressed as a function of age and compared against a previous era of paediatric nephrology and current adult incidence data. Over an 8-year period (1984-1991) 227 children were referred for dialysis management of acute renal failure. The yearly incidence was 0.8 per 100,000 total population. Acute renal failure in the child population was almost a fifth of the adult incidence. Age-related incidence however shows the highest incidence in the neonate/infant population and is comparable to adult data. The intensive care unit was needed for nearly half the children. For all ages hemolytic uremic syndrome was the commonest cause (45%). Surgery for congenital heart disease was predominant (63%) in the neonate group. The overall mortality was 25%. Primary renal disease accounts for only 7% of the etiologies and was the source for the majority that went on to require chronic renal replacement therapy. Acute renal failure is nearly always a secondary event in the face of other organ failure and the majority of the mortality arises from surgery for congenital heart disease. If the underlying condition is treatable, the prognosis for recovery from acute renal failure with appropriate supportive care is excellent.
我们回顾了我们在儿童急性肾衰竭方面的经验。英国利兹的圣詹姆斯大学医院是一家三级转诊中心，服务于相对稳定的地区人口（原约克郡地区）。这是一个城乡混合人口，提供了所经历病例性质和工作量的独特情况。数据表示为年龄的函数，并与儿科肾脏病学的前一个时期以及当前成人发病率数据进行比较。在8年期间（1984 - 1991年），有227名儿童因急性肾衰竭接受透析治疗。年发病率为每10万总人口0.8例。儿童人群中的急性肾衰竭几乎是成人发病率的五分之一。然而，与年龄相关的发病率在新生儿/婴儿人群中最高，并且与成人数据相当。近一半的儿童需要入住重症监护病房。在所有年龄段中，溶血尿毒综合征是最常见的病因（45%）。在新生儿组中，先天性心脏病手术是主要病因（63%）。总体死亡率为25%。原发性肾脏疾病仅占病因的7%，并且是大多数最终需要慢性肾脏替代治疗的病因来源。面对其他器官衰竭，急性肾衰竭几乎总是一个继发性事件，并且大多数死亡源于先天性心脏病手术。如果潜在疾病是可治疗的，在适当的支持治疗下，从急性肾衰竭中恢复的预后非常好。
