Acute Renal Failure
My textbook of Pediatrics by Dr Fe del Mundo defined acute renal failure as a state of sudden cessation or disruption of renal function so that oliguria (urine output of less than 400 ml/M/ 24 hours) or anuria (term for no urine output) ensues, thus producing a disturbance in the internal millieu.
Our kidneys perform three principal functions:
1. They maintain the constancy of the internal environment by adjusting the volume, concentration and composition of the body fluids
2. The kidneys serve to remove from the body various metabolic wastes
3. The kidneys elaborate hormones renin, erythropoietin and the natriuretic hormone.
So, if there is disturbance in the kidneys, then, it will result to a disturbance in the function of the other systems of the body.
The causes of acute renal failure are divided into prerenal, renal and postrenal.
A. Prerenal causes include:
– shock
– burns
– hemorrhage
– dehydration from gastroenteritis and diabetic keto-acidosis
B. Renal causes:
1. Nephrotoxins
– ingestion of mercury, bismuth, ethylene glycol or carbon tetrachloride
2. Infections
– leptospirosis
– typhoid fever
– malaria
– dengue fever
– meningococcemia
3. Renal diseases
4. Iatrogenic
– removal of a solitary kidney
– retrograde contrast studies
5. Undetermined causes
C. Postrenal
– posterior urethral valves
– lithiasis
– instrumentations