Acute Renal Failure in a Tertiary Care Center in Nepal

Abstract

From July 1998 to July 1999, 45 cases of acute renal failure were treated at Bir Hospital, Kathmandu. Out
of which 24 were male and 21 were female. Age ranged from 11 months to 84 years with mean age being 35
years and 9 cases were below 10 years.
Four cases with pre-renal azotaemia and twenty five cases of acute tubular necrosis (ATN) accounted for
64% of all cases. These were due to gastroenteritis 10, sepsis 6, post surgical 1, trauma 1 and obstretical
complications 5. Multiple hornet stings were responsible for acute renal failure in 3 cases, acute urate nephropathy in 1 case and miscellaneous causes in 2 cases.
Glomerulonephritis / vasculitis accounted for 17.7%, acute interstitial nephritis 4.4%, haemotytic uraemic
syndrome (HUS) 6.6%, and post renal azotaemia in 6.6% of all cases. Mean serum creatinine was 8 mg/dl,
mean blood urea 190 mg/dl. Eight cases were treated only conservatively, eighteen received haemodialysis,
fourteen received peritoneal dialysis, three received both and two refused for dialysis. Average duration of
hospital stay was 13.6 days. Out of the forty-five cases twenty-nine recovered normal renal function, ten
expired, two recovered partially, two progressed to chronic renal failure and two left against medical advice.
Overall mortality was 22.2%.
Common causes of acute renal failure in our setting were gastroenteritis (22%) and sepsis (20%). HUS was
exclusively seen in children following bacillary dysentery. Multiple hornet stings is an important cause of
acute renal failure in our country.