Background: Acute renal failure is a common emergency and esspecial dangerous in the neonatal disease group, account for from 8% to 24% of among total patients to be treated at Intensive Care Unit with the high rate of mortality and complication. The mortality rate due to acute renal failure in neonatal group account for from 24.4% to 66,7%. Objectives: This study aims to learn about the clinical and laboratory characteristics as well as some risks factors of neonatal acute renal failure. Subjects and method:A descriptive, retrospective study was conduct on 64 patients without diagnosed of acute renal failure in control group and other 32 cases of acute renal failure whom treated at Neonatal Department of National Hospital for Pediatric from 1st January 2005 to 31st March 2006. Results:The diagnosis was often done in the 1st week of life and the incidence occurred in boy more than in girl.The average reatininernie\r\n', u'was 251.7\xb112.96 \xb5ol/l, the electrical disorder (in which hyperkaliernie: 78.1%, hyponatrernie: 46.9%), anernie was 18.7%, acidosis netabolique was 71.9%. Risk factors of neonatal acute renal failure: the pre-puerperal eclampsia (p = 0.023, OR=1.23), infection (p <0.001, OR = 9.53), suffocation (p <0.05, OR = 2.489), respiratory failure (p <0.001, OR = 2.489). Conclusion: The clinical signs were hyponurie and anuria, oederne and arterial hypertension.\r\n', u'\r\n', u'
Acute Kidney Injury/ diagnosis ; pathology ; Infant

Acute renal cortical necrosis in which there is destruction of the renal cortex and sparing of the renalmedulla, is a relatively rare cause of acute renal failure. A definitive diagnosis of acute renal corticalnecrosis is based on renal biopsy, but on CT(computed tomography) the rather specific contrast-enhanced appearance of acute renal cortical necrosis has been described. As renal biopsy is not available, contrast-enhanced CT is auseful, noninvasive investigate modality for the early diagnosis of acute renal cortical necrosis. We report the characteristic CT findings of acute renal cortical necrosis in a patient with acute renal failure following anoperation for abdominal trauma.
Acute Kidney Injury ; Biopsy ; Diagnosis ; Early Diagnosis ; Humans ; Kidney Cortex Necrosis* ; Tomography, X-Ray Computed*

Acute kidney injury (AKI) has various triggers, such as ischemia, nephrotoxins, radiocontrast, and bacterial endotoxins. It occurs in about one-third of patients treated in the intensive care unit. There is a higher mortality in patients with AKI compared with their non-AKI counterparts. The diagnosis of AKI usually depends on serum creatinine (SCr) measurements. However, SCr is a delayed and unreliable indicator of AKI. The lack of early biomarkers has limited the ability to manage AKI. Fortunately, understanding the early stress response of the kidney to injury has resulted in the identification and validation of several potential novel urine and blood biomarkers. Recently, new biomarkers of AKI with more favorable characteristics than SCr have been identified and studied in various experimental and clinical settings. This article reviews the most well-established biomarkers of AKI.
Acute Kidney Injury* ; Biomarkers* ; Creatinine ; Diagnosis ; Endotoxins ; Humans ; Intensive Care Units ; Ischemia ; Kidney ; Mortality

Idiopathic renal hypouricemia is a disorder characterized by impaired urate handling in the renal tubules. Most patients with hypouricemia are asymptomatic and are found incidentally, but the condition is known to be at high risk for exercise-induced acute renal failure or urolithiasis. URAT1 protein encoded by SLC22A12 gene has been identified recently as a urate/anion exchanger in the human kidney. Inactivation mutations in SLC22A12 gene have been shown to cause renal idiopathic hypouricemia. We experienced a 3-year-old boy who presented with persistent orange-colored urine since infancy. His urine contained many uric acid crystals, while the serum showed hypouricemia(0.7 mg/dL). The fractional excretion of uric acid was increased to 41.7%. SLC22a12 gene analysis revealed W258X homozygote alleles. Renal hypouricemia must be included in the differential diagnosis of red-urine and SLC22A12 gene analysis is recommended in idiopathic renal hypouricemia.
Acute Kidney Injury ; Alleles ; Child, Preschool ; Diagnosis, Differential ; Homozygote ; Humans ; Kidney ; Male ; Uric Acid ; Urolithiasis

Acute Kidney Injury ; classification ; diagnosis ; Humans ; Kidney ; injuries ; Practice Patterns, Physicians'

Acute Kidney Injury ; diagnosis ; etiology ; Biomarkers ; Early Diagnosis ; Humans ; Liver Cirrhosis ; complications ; diagnosis

PURPOSE:Fractional excretion of sodium (FENa) has been used in the differentiation of acute kidney injury (AKI) into traditional categories of prerenal azotemia (PR) and acute tubular necrosis (ATN). However, many patients with PR have already received diuretics or saline at the time of diagnosis, which increase FENa. In contrast, the fractional excretion of uric acid (FEUA) and urea (FEUN) is less influenced by diuretics. We investigated the diagnostic significance of the FEUA and FEUN in differentiating between PR and ATN. METHODS:The FENa, FEUA, and FEUN were calculated in 40 patients with PR and 30 patients with ATN at day 0 (D0), day 1 (D1) and day 2 (D2), sequentially. RESULTS:FEUA (PR 13.9+/-8.7% vs. ATN 33.2+/-27.0%, p<0.05) and FEUN (PR 32.1+/-18.9% vs. ATN 50.6+/-41.3%, p<0.05) were lower in PR than in ATN patients. At the cut-off value of 1% FENa, sensitivity and specificity for the detection of PR was 51.4% and 96.4%, respectively. When FENa, FEUA and FEUN were combined, sensitivity and specificity was 84% and100%, respectively. In the PR with FENa less than 1%, FENa significantly increased after treatment (D0 0.4+/-0.1% vs. D1 1.2+/-0.3% vs. D2 1.5+/-0.4 %, p<0.05), but FEUA and FEUN did not changed after treatment. CONCLUSION:FEUA and FEUN may be useful in differentiating between PR and ATN. The combination of FENa, FEUA and FEUN might increase diagnostic sensitivity and specificity in the differential diagnosis of AKI.
Acute Kidney Injury ; Azotemia ; Diagnosis, Differential ; Diuretics ; Humans ; Necrosis ; Sensitivity and Specificity ; Sodium ; Urea ; Uric Acid ; Urinalysis

Paroxysmal nocturnal hemoglobinuria(PNH) is an acquired hematologic disorder characterized by intravascular hemolysis, nocturnal hemoglobinuria, thrombotic events and bone marrow failure. It rarely occurs in children and can be complicated by acute renal failure(ARF). Here, we present two cases of ARF complicating PNH which has not been reported yet in Korean children. We suggest that PNH should be considered in differential diagnosis of ARF in children associated with intravascular hemolysis.
Acute Kidney Injury ; Bone Marrow ; Child ; Diagnosis, Differential ; Hemoglobinuria ; Hemoglobinuria, Paroxysmal ; Hemolysis ; Humans

Acute kidney injury is a common and serious complication after major cardiovascular surgery and is independently associated with poor short- and long-term outcomes. The pathogenesis of cardiac surgery-associated acute kidney injury is complex and involves multiple pathways including hemodynamic, inflammatory, metabolic and nephrotoxic factors. Three definitions of acute kidney injury based on serum creatinine and urine output (RIFLE, AKIN, and KDIGO criteria) have been proposed and validated. Several novel biomarkers of acute kidney injury have been developed to facilitate the subclinical diagnosis of acute kidney injury, as well as the better risk stratification of patients. Despite the high-quality research conducted in this field to date, there is very little evidence supporting specific interventions to treat acute kidney injury in patients undergoing cardiovascular surgery. Thus, early identification of high-risk patients and preventing cardiac surgery-associated acute kidney injury by mitigating risk factors or avoiding renal insults remains the mainstay of management. Although some strategies have shown promising results in renoprotection, further large randomized trials are needed to confirm the benefit of such approaches.
Acute Kidney Injury* ; Biomarkers ; Creatinine ; Diagnosis ; Hemodynamics ; Humans ; Risk Factors ; Thoracic Surgery*

Acute renal failure secondary to acute pyelonephritis is developed rarely. But acute pyelonephritis is considered in differential diagnosis of acute renal failure, particularly in elderly patient. Elderly patient showed subtle symptoms or signs of infections and can be missed easily. We experienced two cases of acute renal failure secondary to acute pyelonephritis. In first case, one patient complained fever, chilling and right flank pain for 10 days. Three repeated blood and urine cultures showed E. coli, respectively. At admission serum creatinine showed 2.4 mg/dL and thereafter increased to 4.5 mg/dL, and then decreased to 1.7 mg/dL with antibiotic therapy and hydration at 14 days of admission. In second case, patient complained right flank pain, costovertebral tenderness and urinary difficulty at admission. Two repeated blood culture showed no growth, two repeated urine culture showed > 105 ml/dL of E. coli. At admission serum creatinine level was 2.69 mg/dL and then decreased to 1.7 mg/dL with antibiotic therapy and hydration at 14 days of admission.Acute pyelonephritis should be considered in differential diagnosis of acute renal failure in the elder ages, although this developed rarely. Early recognition and appropriate antibiotic treatment helps recover acute renal failure secondary to acute pyelonephritis.
Acute Kidney Injury* ; Aged ; Creatinine ; Diagnosis, Differential ; Fever ; Flank Pain ; Humans ; Pyelonephritis*