Acute unexplained renal failure of infancy and childhood is a rewarding condition to treat. Of 27 children referred for acute dialysis, only 3 died. Half were managed without dialysis, and of those dialysed, 6 recovered full or adequate renal function while 6 had end-stage renal disease requiring transplantation or regular dialysis.
Complications of the nephrotic syndrome causing hypovolaemic uraemia were a major cause of referral. Septicaemia was commonly associated with renal failure regardless of its aetiology.
The child in acute renal failure requires considerable resources in addition to dialysis. Therefore, peritoneal dialysis should not be started in paediatric units which do not have the skills and services required for full investigation and care.
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