№ 31General Pediatrics19 min read
Acute and chronic renal failure
1. Big picture
In pediatrics, renal failure means the kidneys cannot maintain normal fluid, electrolyte, acid-base, and waste-product balance.
The examiner usually wants you to separate two different clinical pictures:
| Type | Core idea | Typical exam pattern |
|---|---|---|
| Acute renal failure / acute kidney injury | Sudden fall in kidney function over hours-days | Oliguria/anuria, rising creatinine, hyperkalemia, acidosis, fluid overload |
| Chronic renal failure / chronic kidney disease | Persistent kidney damage or low glomerular filtration rate for ≥ 3 months | Growth failure, anemia, hypertension, bone disease, polyuria/nocturia, uremic symptoms |
The most urgent pediatric danger is acute kidney injury with hyperkalemia, pulmonary edema, severe acidosis, hypertension, or uremic encephalopathy.
ACUTE RENAL FAILURE / ACUTE KIDNEY INJURY
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