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Varna Medical Forum

Algorithm of behavior in children with acute kidney failure

Dora Vasileva, Dimitrichka Bliznakova, Magdalena Bliznakova


Acute kidney failure (AKF, also called acute kidney injury - AKI) is a clinical laboratory syndrome occurring with acute failure of basic kidney functions: homeostasis, excretion, regulation. The frequency of AKF in childhood ranges from 20 cases per year per
100,000 population in neonates to 2 cases per year per 100 000 in adolescents. AKF is one of the most dramatic conditions in pediatric nephrology.

AKF proceeds with oliguria, hyperkalemia, oedema, tachycardia, arterial hypertension. The causes of AKF are commonly categorized into prerenal, intrinsic, and postrenal.

The algorithm of behavior includes: a history of nausea, vomiting, diarrhea and pain syndrome, surgery, exogenous effects, congenital disorders, recurrent urinary tract infections, nephrolithiasis, status (degree of dehydration, pallor of the skin and visible mucous membranes), laboratory evaluation (CRP, urea, creatinine, uric acid, total protein, detailed ionogram, coagulation status, urine analysis) and intensive care treatment. Healthcare includes: monitoring of temperature, diuresis (indwelling catheter). Basic vital signs - body temperature, blood pressure, heart rate and respiratory rate also must be monitored.

Development of good therapeutic strategy is part of the management of this serious kidney condition.


acute kidney failure; childhood; algorithm; healthcare

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