소아에서의 급성 신성신부전의 임상적 고찰
Clinical Analysis of Acute Intrinsic Renal Failure in Neonates and Children
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose:The present study is an investigation of the progression and prognosis of acute intrinsic renal failure in neonates and children with a diagnosis of acute renal failure or other diseases on admission. Methods:This research is based on a retrospective analysis conducted on 59 patients(male: female=2.2:1) diagnosed with acute intrinsic renal failure between January 2000 and June 2006 at Busan Paik Hospital. The clinical diagnostic criteria of acute renal failure used was serum creatinine <1.2 mg/dL, oliguria with urine output≤0.5 mL/kg/hr and anuria with urine output <50 mL per day. Results:Among those placed under investigation, 7 patients were neonates, 10 patients were 2 months-2 years old, 12 patients were 3-6 years old, 21 patients were 7-12 years old and 9 patients were 13-16 years old. It took 3.1±2.8 days on average until the diagnosis was made. The urine output distribution was 21 persons for the oliguria group, and 36 persons for the non-oliguria group, and 2 persons for the anuria group. For the underlying causes, 30 persons were classified in the primary renal disease group, 14 persons in the infection group, 9 persons in the malignancy group, and 6 persons were categorized in another group. As for age distribution, the infected group was predominantly neonates, whereas the dominant age ranges for the primary renal disease and infection categories were 2 months to 2 years old. Also, the primary renal disease was dominant among older children, aged 3 and up. No difference was detected according to seasonal prevalence. However, there was a high morbidity rate among hemolytic uremic syndrome diagnosed in the summer. Peritoneal dialysis was used to treat 4 patients. It took 10.0±6.7 days until the patients improved. 18 patients died. The non-oliguria group's mortality rate was lower than other groups. There was a high mortality rate in the neonates and malignancy group. Conclusion:Acute renal failure in childhood seems to take a better clinical course than in adulthood when there is an early diagnosis and proper treatment of underlying diseases.
Abstract
Purpose:The present study is an investigation of the progression and prognosis of acute intrinsic renal failure in neonates and children with a diagnosis of acute renal failure or other diseases on admission. Methods:This research is based on a retrospective analysis conducted on 59 patients(male: female=2.2:1) diagnosed with acute intrinsic renal failure between January 2000 and June 2006 at Busan Paik Hospital. The clinical diagnostic criteria of acute renal failure used was serum creatinine <1.2 mg/dL, oliguria with urine output≤0.5 mL/kg/hr and anuria with urine output <50 mL per day. Results:Among those placed under investigation, 7 patients were neonates, 10 patients were 2 months-2 years old, 12 patients were 3-6 years old, 21 patients were 7-12 years old and 9 patients were 13-16 years old. It took 3.1±2.8 days on average until the diagnosis was made. The urine output distribution was 21 persons for the oliguria group, and 36 persons for the non-oliguria group, and 2 persons for the anuria group. For the underlying causes, 30 persons were classified in the primary renal disease group, 14 persons in the infection group, 9 persons in the malignancy group, and 6 persons were categorized in another group. As for age distribution, the infected group was predominantly neonates, whereas the dominant age ranges for the primary renal disease and infection categories were 2 months to 2 years old. Also, the primary renal disease was dominant among older children, aged 3 and up. No difference was detected according to seasonal prevalence. However, there was a high morbidity rate among hemolytic uremic syndrome diagnosed in the summer. Peritoneal dialysis was used to treat 4 patients. It took 10.0±6.7 days until the patients improved. 18 patients died. The non-oliguria group's mortality rate was lower than other groups. There was a high mortality rate in the neonates and malignancy group. Conclusion:Acute renal failure in childhood seems to take a better clinical course than in adulthood when there is an early diagnosis and proper treatment of underlying diseases.
참고문헌 (23)
- Chan JC, "Kidney failure in infants and children", Pediatr Rev, 23, pp.47~60 (2002)
- Moghal NE, "A review of acute renal failure in children: incidence, etiology and outcome", Clin Nephrol, 49, pp.91~95 (1998)
- Reimold EW, "Renal failure during the first year of life", Pediatrics, 59, pp.987~994 (1977)
- 한혜원, "소아의 급성 신부전증", 소아과, 50(10), pp.948~953 (2007), 대한소아과학회
- Robert JA, "Acute renal failure in: Diseases of the kidney and urinary tract", pp.1093~1136 (1993), Little Brown
- Paniagua GG, "Acute renal failure", Pediatr clin North Am, 23, pp.817~828 (1976)
- Park BL, "Acute renal failure in children", Korean J Pediatr, 25, pp.141~147 (1982)
- Son CL, "Acute renal failure in children", Korean J Pediatr, 27, pp.146~155 (1984)
- Jang CK, "Prognostic factors of renal type acute renal failure in neonates and children", Korean J Nephr, 14, pp.4665~472 (1995)
- Kim KB, "Clinical observations on acute renal failure", Korean J of Med, 26, pp.243~250 (1983)
- Kim SS, "Clinical study of acute renal failure treated by hemodialysis", Korean J of Med, 39, pp.783~793 (1990)
- Turney JH, "The evolution of acute renal failure", QJ Med, 74, pp.83~104 (1988)
- Garabed E, "Acute renal failure associated with tubulointerstitial nephropathies in: Acute renal failure", pp.491~534 (1993), Chuchill living stone
- Ahn HS, "Pediatrics", pp.886~900 (2007), DaeHan
- Lee SS, "Clinical observations of oliguric acute renal failure in children", J Korean Pediatr Soc, 42, pp.1419~1425 (1999)
- Anderson RJ, "Nonoliguric acute renal failure", N Engl J Med, 196, pp.1134~1138 (1977)
- Anand SK, "Acute renal failure in newborn infants", J Pediatr, 92, pp.985~988 (1978)
- Mathew OP, "Neonatal renal failure: usefulness of diagnostic indices", Pediatrics, 65, pp.57~60 (1980)
- Fisher RP, "Early dialysis in the treatment of acute renal failure", Surg Gynecol Obstet, 123, pp.1019~1023 (1966)
- Hodson EM, "Acute renal failure in infants and children: outcome of 53 patients requiring hemodialysis treatment", J Pediatr, 93, pp.756~761 (1978)
- Niaudet P, "Broyer M. Outcome of children with acute renal failure", Kidney Int suppl, 17, pp.148~151 (1985)
- Andreoli SP, "Acute renal failure in the newborn", Semin Perinatol, 28, pp.112~123 (2004)
- Barletta GM, "Acute renal failure in children and infants", Curr Opin Crit Care, 10, pp.499~504 (2004)