TITLE:
Acute Renal Failure in Children at the University Hospital of Brazzaville
AUTHORS:
Engoba Moyen, Verlem Bomelefa-Bomel, Gaston Ekouya-Bowassa, Tony Eyeni Sinomono, Aymar Pierre Gildas Oko, Bertrand Fikahem Ellenga Mbolla, Georges Marius Moyen
KEYWORDS:
Acute Renal Failure, Child, Brazzaville
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.9 No.3,
September
30,
2019
ABSTRACT: Introduction: Acute renal failure (ARF) is a medical emergency that does not spare
children. Its interest lies in the search for etiologies and management made
difficult by the poor quality of hospital technical platform in Africa. Objectives: To improve the management of ARF in children, determine its prevalence, and identify
the causes and factors associated with mortality. Patients and Methods: We
reviewed the records of children from one month to 17 years hospitalized
between January 2016 and December 2018 in every pediatric department at the
University Hospital of Brazzaville and included those whose discharge diagnosis
included the item “ARF”. Study variables were age, sex, source, (para)clinical signs, stage and type of ARF, etiology and
evolutionary profile. Results: Included were 18952 hospitalized children
out of whose 253 had ARF 1.3%. There were
145 (57.3%) boys and 108 (42.7%) girls with an average age of 71.5 months. The mean time to consultation was 8.1 days.
ARF was at failure stage in 147 cases (58.1%). It was functional in 210 cases
(83.0%), out of which 95.1% resulted from severe dehydration. No extra-renal
treatment was performed. Lethality was 34.4%. Hypovolemic shock (56.3%), severe
sepsis (18.4%) and severe malaria (14.9%) were the main causes. Young age,
provenance of the child, severe dehydration, deep coma, oligoanuria, stage of
failure, hyperkalemia, absence of an extra-renal purification center were
factors associated with mortality (p Conclusion: The high
prevalence of ARF and its lethality requires public health actions including
proper management of dehydration and malaria but also the creation of an
extra-renal purification center.