• Clinical and Experimental Pediatrics
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• v.50 no.10
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• pp.948-953
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• 2007

Acute renal failure is the generic term for an abrupt and sustained decrease in renal function resulting in retention of nitrogenous and non nitrogenous waste product. This may results in life threatening consequences including volume overload, hyperkalemia, and metabolic acidosis. Acute renal failure is both common and carries high mortality rate, but as it is often preventable, identification of patients at risk and and appropriate management are crucial. This review summarized the most recent information on definition, epidemiology, clinical causes and management of acute renal failure in pediatric patients.

• Journal of Veterinary Clinics
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• v.18 no.1
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• pp.35-43
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• 2001

Present study was undertaken in order to document early renal ultrasonographic changes of gentamicin nephrotoxicosis and to show the value of renal ultrasonography as a contributory means of early diagnosis of acute renal failure in dogs. The experimental design was a randomized complete block design with six treatments in two blocks (gentamicin-treated & saline-treated). Acute renal failure was induced by toxic dosage of gentamicin (30 mg/kg) and saline solution sham equivalent in volume to that of the toxic dosage of gentamicin (1.5-3ml). Subjective visualization of increased renal cortex was visible as homogenous echoes that were hypoechoic relative to the surrounding tissues, whereas the renal medulla was anechoic to slightly hypoechoic. After treatment, the renal cortex was hyperechoic relative to the surrounding tissue. Increased renal cortex echogenicity was associated with significant nephrotoxicosis and was superior to serum creatinine elevation in nephrotoxicosis detection. Urine GGT was superior to other clinicopathological data utilized in the diagnosis of nephrotoxicosis. Based on the above results, increased renal cortex echogenicity seemed to be of use in detecting of acute renal failure.

• Journal of Sasang Constitutional Medicine
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• v.17 no.3
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• pp.103-112
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• 2005

1. Objective : The present author have examined the comparative effects of Hyeongbangjihwang-tang and Sibimikwanjung-tang in glycerol-induced acute renal failure, a model for myoglobinuric acute renal failure. 2. Methods : Above two prescriptions were applied to rat ad libitum and serum level of creatinine, glucose and blood urea nitrogen(BUN) were measured. And serum level of $Na^+$, $K^+$ and $Cl^-$, too. 50%(vol/vol) glycerol at a dose of 10 ml/kg of rat body weight intramuscularly and 1% concentration of prescriptions were applied to rats for 7 days ad libitum. 3. Results : Serum level of creatinine and $K^+$ significantly increased by glycerol injection, and these showed pre-renal and renal cause of acute renal failure. Hyeongbangjihwang-tang administered group showed decreasing tendency on serum level of creatinine when compared with control groups, but not significant. Sibimikwanjung-tang administered group showed significant increase of serum level of BUN when compared with control groups. 4. Conclusions : Above two prescriptions showed no significant changes on glycerol induced acute renal failure, but Hyeongbangjihwang-tang and Sibimikwanjung-tang showed a little different manner of response.

• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.2
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• pp.83-89
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• 2009

Purpose: Rhabdomyolysis is one of the most important complications of pesticide intoxication. It affects a patient's clinical prognosis and can cause acute renal failure. It is important that patients diagnosed with pesticide intoxication receive an accurate initial diagnosis and proper treatment to prevent significant complications. This study's objective was to investigate and confirm related factors causing acute renal failure by verifying clinical observations and laboratory findings collected following pesticide intoxication. Methods: A retrospective analysis was made of 734 patients who presenting to our emergency medical center after ingesting pesticides between January 2006 and December 2008, Of these, 513 patients were selected for the study. Two hundred and twenty-one patients were excluded because of paraquat intoxication, age (if under 18), or chronic renal failure. Seventy-four patients were diagnosed with rhabdomyolysis, based on serum creatinine phosphokinase levels were > 1,000U/L. Acute renal failure was diagnosed when creatinine levels were > 2.0 mg/dL. Results: Among the 74 patients diagnosed with rhabdomyolysis, 26 (35.1%) experienced acute renal failure. The most meaningful related factor in the prediction of acute renal failure was initial arterial pH and creatinine level. Conclusion: Initial arterial pH and creatinine level are predictors of complications such as acute renal failure in patients with rhabdomyolysis.

• Journal of Yeungnam Medical Science
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• v.27 no.2
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• pp.127-132
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• 2010

Acute hepatitis A is a generally self-limiting disease of the liver. Acute renal failure is rare in patients with acute non-fulminant hepatitis A Acute tubular necrosis is the most common form of renal injury found in such patients. The 215 years old male patient visited our hospital with complaint of general weakness, fatigue, nausea, vomiting and myalgia. He was diagnosed with acute renal failure associated with acute non-fulminant hepatitis A We report here on a case of acute renal failure associated with non-fulminant hepatitis A, and we include a review of the literature.

• Journal of Yeungnam Medical Science
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• v.1 no.1
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• pp.13-23
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• 1984

Acute renal failure refers to a rapid reduction in renal function that usually occurs in an individual with no known previous renal disease. Development of a complication of acue renal failure in critically ill surgical patients is not unusual, and it causes high morbidity and mortality. Acute renal failure can be divided as Pre-renal (functional), Renal (organic), and Post-renal (obstructive) azotemia according to their etiologies. Early recognition and proper correction of pre-renal conditions are utter most important to prevent an organic damage of kidney. These measures include correction of dehydration, treatment of sepsis, and institution of shock therapy. Prolonged exposure to ischemia or nephrotoxin may lead a kidney to permanent parenchymal damage. A differential diagnosis between functional and organic acute renal failure may not be simple in many clinical settings. Renal functional parameters, such as $FENa^+$ or renal failure index, are may be of help in these situations for the differential diagnosis. Provocative test utilyzing mannitol, loop diuretics and renovascular dilators after restoration of renal circulation will give further benefits for diagnosis or for prevention of functional failure from leading to organic renal failure. Converting enzyme blocker, dopamine, calcium channel blocker, and propranolol are also reported to have some degree of renal protection from bioenergetic renal insults. Once diagnosis of acute tubular necrosis has been made, all measures should be utilized to maintain the patient until renal tubular regeneration occurs. Careful regulation of fluid, electrolyte, and acid-base balance is primary goal. Hyperkalemia over 6.5 mEq/l is a medical emergency and it should be corrected immediately. Various dosing schedules for medicines excreting through kidney have been suggested but none was proved safe and accurate. Therefore blood level of specific medicines better be checked before each dose, especially digoxin and Aminoglycosides. Indication for application of ultrafiltration hemofilter or dialysis may be made by individual base.

• Journal of Chest Surgery
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• v.14 no.4
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• pp.319-323
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• 1981

To clarify the clinical spectrum of non-oliguric acute renal failure, we undertook a retrospective study of 16 cases of acute renal failure following trauma and surgery, 6 of whom were non-oliguric throughout their periods of azotemia. With the clinical symptoms, BUN, creatinine and some urinary diagnostic indexes, we analyzed the differences between non-oliguric and oliguric renal failure. And the results were: 1. The nonoliguric form [10 cases] was more common than oliguric [6 cases], especially post-traumatic failure. 2. The both types belonged to parenchymal renal failure by the U/P UN ratio and urinary Na concentration [Vertal, 1967]. 3. The non-oliguric form was lesser severe in urinary diagnostic indexes and clinically. The non-oliguric renal failure has better clinical course and prognosis, the failure to diagnose it is as dangerous as the failure oliguric renal failure.

• Childhood Kidney Diseases
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• v.10 no.2
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• pp.228-232
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• 2006

Acute interstital nephritis can occur by acetaminophen, but it is rarely presented as acute renal failure with azotemia. We report a case of acute interstitial nephritis induced by acetaminophen in a 14-year-old girl who developed non-oliguric acute renal failure. She has taken acetaminophen to control the persistent throat pain for the last two months. Renal biopsy revealed diffuse infiltration of mononuclear inflammatory cells admixed with eosinophils in the edematous interstitia. After the discontinuation of acetaminophen and the administration of corticosteroid, the serum creatinine level returned to normal.

• Journal of Chest Surgery
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• v.27 no.2
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• pp.122-127
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• 1994

A retrospective study of 737 consecutive patients surviving the first 24 hours who underwent valve replacement surgery from July 1980 to June 1993 was undertaken to determine the prevalence, variables that could be used to predict outcome and results of therapy for postoperative acute renal failure[ARF]. Twenty-one patients[2.8 %] developed acute renal failure. Positive risk factors noted in the development of postoperative renal failure included age, New York Heart Association class III & IV, endocarditis and elevated preoperative concentration of serum creatinine. The duration of cardiopulmonary bypass, aortic cross-clamping and the total duration of the operation also closely correlated with the incidence of ARF. The mortality rate for established ARF was 38.1% and ARF was associated with a significant increase in the length of hospitalization, ventilator support and intensive care unit stay. The incidence and mortality rate of oliguric renal failure was 38.1% and 85.7%. The highest mortality rate was associated with two or more postoperative complications and serum creatinine value exceeded 5 mg/dl. We concluded that therapy should be aimed at prevention of oliguric renal failure, or at least its conversion to nonoliguric renal failure, and early institution of renal replacement therapy with intensive support probably gives the best chance for survival.

• Korean Journal of Pharmacognosy
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• v.33 no.3 s.130
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• pp.200-206
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• 2002

The rhizoma of Polygonatum odoratum (Liliaceae) has been used as the treatment of body fluid deficiency, dryness symptoms and hyper glycemia. To study effects on acute renal failure of P. odorati rhizoma, urinary volume, urinary electrolytes and serum factors associated with renal dysfunction were measured in $HgCl_2-induced$ acute renal failure rats. It was revealed that its ether ex. had significant diuretic effects, regulated hypoelectrolytes$(Na^+,\;K^+,\;Cl^-)$ and inhibited the increase of creatinine, BUN in acute renal failure rats. From the ether ex. which was more effective than MeOH ex., three lipophilic compounds were isolated and elucidated hydrocarbon(l), ${\beta}-sitosteryl$ stearate(2), ${\beta}-sitosterol$(3). The ${\beta}-sitosteryl$ stearate(2) were isolated from Polygonatum sp. at first.