Acute renal failure in moroccan children.

To evaluate the etiology and prognosis of acute renal failure (ARF) in Moroccan children, we retrospectively studied 120 cases of ARF that presented to two centers in Casablanca, Morocco between 1982 and 1999. There were 72 (60%) boys and 48 (40%) females with age that ranged between six months and 15 years with a mean of 6.8 +/- 5.0 years. All patients received appropriate medical treatment, while 76 (74%) patients required dialysis; peritoneal dialysis in 31 (40%) patients and hemodialysis in 45 (60%). Emergency dialysis was performed in 37 (48.7%) patients due to severe sodium and water overload and/or severe hyperkalemia, while dialysis was initiated in 39 (51.3%) because of high blood urea and creatinine levels. Predialysis serum urea nitrogen (BUN) exceeded 33 mmol/l in all of these cases and the mean was 51 mmol/l. The causes of ARF included acute glomerulonephritis (GN) in 61 (50.8%), hemolytic uremic syndrome (HUS) in 18 (15%), renal hypoperfusion in 12 (10%), acute interstitial nephritis in 9 (7.5%), urinary tract obstruction in 7 (5.9%) and the cause was not identified in 13 (10.8%). Mortality rate was 17%; recovery rate was higher in the non-oliguric patients. Outcome was favorable in 65% of the patients with glomerular disease. Most patients in this study did not require intensive care and none had neonatal ARF, which is known to carry poor prognosis.