Kidney failure in infants and children.

Introduction The evaluation of kidney failure is challenging, despite many advances in diagnosis and treatment over the past decade. To provide pediatricians with an informed choice, this article reviews both acute and chronic renal failure, their multiple causes, the principles of treatment, and both shortand long-term outcomes. Acute renal failure (ARF) is characterized by the abrupt failure of the kidneys to regulate water and electrolyte homeostasis. ARFs in childhood due to hemolytic-uremic syndrome, postinfectious acute glomerulonephritis, or dehydration are reversible, but a small percentage may progress to chronic renal failure (CRF). CRF is the result of slowly progressive kidney diseases and seldom is fully reversible. This condition in childhood is associated with obstructive uropathy, congenital aplastic/hypoplastic/dysplastic kidneys, and other causes. In CRF, almost every system in the body eventually becomes compromised.