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April 1958, Vol 95, No. 4 >
Article | April 1958

Acute Tubular Necrosis in Infancy and Childhood FREE

GEOFFREY C. ROBINSON, M.D., F.R.C.P. (C); LEI CHING WONG, M.D.
[+] Author Affiliations

Submitted for publication Aug. 16, 1957; accepted Sept. 5.


AMA Am J Dis Child. 1958;95(4):417-433. doi:10.1001/archpedi.1958.02060050421012.
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Comments

Introduction  Acute renal failure is a clinical syndrome characterized by the sudden onset of severe oliguria or anuria followed by the retention of excretory products. It may be due to either reversible or irreversible lesions in the kidneys or urinary passages. In the majority of cases the lesion is reversible, provided an early diagnosis is made and appropriate management is instituted. Cases which prove to be irreversible may be very difficult to diagnose as such during life, particularly during the early course of the syndrome, and consequently they often merit essentially the same plan of management as the former group.Acute tubular necrosis is now recognized as an important cause of acute reversible renal failure. For many years the existence of acute renal failure due to a variety of different etiological agents had been recognized.1 During the past 15 years, it has been established that degeneration in the epithelium

REFERENCES

1 +
Osler, W.: Principles and Practice of Medicine , Ed. 2, New York, Appleton-Century-Crofts Company, 1895;, p. 763.
2 +
Oliver, J.; MacDowell, M., and Tracy, A.:  The Pathogenesis of Acute Renal Failure Associated with Traumatic and Toxic Injury , J. Clin. Invest. 30:1305, 1951;.
3 +
Peters, J. P.:  Oliguria and Anuria Due to Increased Intrarenal Pressure , Ann. Int. Med. 23: 221, 1945;.
4 +
Waugh, D.:  Acute Nephrosis: The Kidney of Acute Renal Failure , Am. J. M. Sc. 226:310, 1953;.
5 +
Swann, R. C., and Merrill, J. P.:  The Clinical Course of Acute Renal Failure , Medicine 32:215, 1953;.
6 +
Ponfick, E.: Berlin. klin. Wchnschr. 20:389, 1883;, cited by Waugh.4
7 +
Bywaters, E. G. L., and Beall, D.:  Crush Injuries with Impairment of Renal Function , Brit. M. J. 1:427, 1941;.
8 +
Lauson, H. D.; Bradley, S. E., and Cournand, A.:  The Renal Circulation in Shock , J. Clin. Invest. 23:381, 1944;.
9 +
Selkurt, E. E.:  Renal Blood Flow and Renal Clearance During Hemorrhagic Shock , Am. J. Physiol. 145:699, 1946;.
10 +
Lucke, B.:  Lower Nephron Nephrosis , Mil. Surgeon 99:371, 1946;.
11 +
Mallory, T. B.:  Hemoglobinuric Nephrosis in Traumatic Shock , Am. J. Clin. Path. 17:427, 1947;.
12 +
Kugel, V. H.:  Management of Acute Toxic Nephrosis , Am. J. Med. 3:188, 1947;.
13 +
Pratt, E. L.:  Treatment of Anuria , Am. J. Dis. Child . 74:730, 1947;.
14 +
Strauss, M. B.:  Acute Renal Insufficiency Due to Lower Nephron Nephrosis , New England J. Med. 239:693, 1948;.
15 +
Strauss, M. B., and Raisz, L. G.:  Treatment of Acute Renal Shutdown , A. M. A. Arch. Int. Med. 95:846, 1955;.
16 +
Wagner, J.:  Acute Tubular Necrosis with Anaemia , Great Ormond St. J. 7:66, 1954;.
17 +
Erganian, J. A., and Doval, J. A.:  Fatal Anuria Following Administration of Sulfonamides with Reference to Tubular Necrosis and Regeneration , J. Lab. & Clin. Med. 28:808, 1943;.
18 +
Press, E., and Kennerstein, M.:  Additional Manifestation of Sulphathiazole Toxicity: Non-Calculous Renal Insufficiency Following the Use of Sulphathiazole , Arch. Dis. Childhood 18:50, 1943;.
19 +
Higgins, T. T.; Williams, D. I., and Nash, D. F. E.: The Urology of Childhood , London, Butterworth & Co., Ltd., 1951;, p. 33.
20 +
Dintenfass, A.:  Allergic Manifestation to Sulfamerazine, with 2 Case Reports of Anuria in Children , Ohio M. J. 41:628, 1945;.
21 +
Riddell, H. I.:  The Lower Nephron Syndrome in Children , J. Urol. 65:177, 1951;.
22 +
Redish, J.; West, J. R.; Whitehead, B. W., and Chase, H.:  Abnormal Renal Tubular Back-Diffusion Following Anuria , J. Clin. Invest. 26: 1043, 1947;.
23 +
McClendon, S. J.:  Toxic Effects with Anuria from Single Injection of Bismuth Preparation , Am. J. Dis. Child . 61:339, 1941;.
24 +
Boyette, D. P.:  Bismuth Nephrosis with Anuria in Infant , J. Pediat. 28:493, 1946;.
25 +
Petersilge, C. L.:  Prolonged Anuria Following Single Injection of Bismuth Preparation , J. Pediat. 31:580, 1947;.
26 +
Hoffman, W. S., and Marshall, D.:  Management of Lower Nephron Nephrosis , Arch. Int. Med. 83:249, 1949;.
27 +
Karelitz, S., and Freedman, A. D.:  Hepatitis and Nephrosis Due to Soluble Bismuth , Pediatrics 8:772, 1951;.
28 +
Dunsky, I.:  Potassium Bromate Poisoning , Am. J. Dis. Child . 74:730, 1947;.
29 +
Thompson, H. C., and Westfall, S. W.:  Potassium Bromate Poisoning , J. Pediat. 34:362, 1949;.
30 +
Swan, H., and Gordon, H.:  Peritoneal Lavage in the Treatment of Anuria in Children , Pediatrics 4:586, 1949;.
31 +
Warren, S. A., and Gross, W. V., Jr.:  Clinical Recovery Following Prolonged Anuria in an Infant 2 Months of Age , Pediatrics 5:954, 1950;.
32 +
Kaplan, S. A., and Fomon, S. J.:  Function Recovery Pattern in Acute Renal Failure Following Ingestion of Mercuric Chloride , A. M. A. Am. J. Dis. Child . 85:633, 1953;.
33 +
Goodpaster, W. E.; Levenson, S. M.; Tagnow, H. J.; Lind, C. C., and Taylor, F. H. L.:  Clinical and Pathological Study of the Kidney in Patients with Thermal Burns , Surg. Gynec. & Obst. 82:652, 1946;.
34 +
Martineau, P. C., and Hartman, F. W.:  Renal Lesions in Extensive Cutaneous Burn , J. A. M. A. 134:429, 1947;.
35 +
Carter, F. H.; Aoyama, S.; Mercer, R. D., and Kolff, W. J.:  Hemodialysis in Children: Report of 5 Cases , J. Pediat. 51:125, 1957;.
36 +
Wahle, G. H., Jr., and Muirhead, E. E.:  Bilateral Renal Cortical Necrosis in a Child Associated with an Incompatible Blood Transfusion , Texas J. Med. 49:770, 1953;.
37 +
Buerger, W. R.; Lambert, E. C., and Maitland, B. A. A.:  Peritoneal Irrigation: Method of Treatment of Acute Renal Failure in an Infant , Am. J. Dis. Child . 78:237, 1949;.
38 +
Zuelzer, W. W.; Charles, S.; Kurnetz, R.; Newton, W. A., Jr., and Fallon, R.:  Circulatory Diseases of the Kidneys in Infancy and Childhood , A. M. A. Am. J. Dis. Child. 81:1, 1951;.
39 +
Mateer, F. M.; Greenman, L., and Danowski, T. S.:  Hemodialysis of the Uremic Child , A. M. A. Am. J. Dis. Child. 89:645, 1955;.
40 +
Schwartz, R.; Tomsovic, E. J., and Schwartz, I. I.:  Hyperpotassemia and Body Water Disturbance in an Anuric Child , Pediatrics 7:516, 1951;.
41 +
Jonsson, B.:  Lower Nephron Nephrosis in Asphyxia Neonatorum , Acta paediat. 40:401, 1951;.
42 +
Meroney, W. H., and Herndon, R. F.:  Management of Acute Renal Insufficiency , J. A. M. A. 155:877, 1954;.
43 +
Rubin, M. I., and Calcagno, P. L.:  Renal Disease in Infants and Children , Pediatrics 17: 781, 1956;.
44 +
Whitelaw, W.:  Case of Anuria Lasting 25 Days: Recovery , Lancet 2:460, 1877;.
45 +
Tamaki, H. T., and Whitman, M. A.:  Hemorrhagic Papillary Necrosis of the Kidney , J. A. M. A. 150:1304, 1952;.
46 +
Keitzer, W. A.:  Acute Uremia , J. Urol. 73: 920, 1955;.
47 +
Teschan, P. E.; Post, R. S.; Smith, L. H., Jr.; Abernathy, R. S.; Davis, J. H.; Gray, D. M.; Howard, J. M.; Johnson, K. E.; Klopp, E.; Mundy, R. L.; O'Meara, M. P., and Rush, B. F., Jr.:  Post-Traumatic Renal Insufficiency in Military Casualties: I. Clinical Characteristics , Am. J. Med. 18: 172, 1955;.
48 +
Luetscher, J. A., Jr., and Blackman, S. S., Jr.:  Severe Injury to Kidneys and Brain Following Sulfathiazole Administration: High Serum Sodium and Chloride Levels and Persistent Cerebral Damage , Ann. Int. Med. 23:741, 1943;.
49 +
Barclay, T. L., and Wallace, A. B.:  Management of Burns: II. Fluid Replacement in Burned Patients , Lancet 1:98, 1954;.
50 +
Hall, A. D., and Luetscher, J. A., Jr.:  Renal Disease , New England J. Med. 239:621, 1948;.
51 +
Mollison, P. L.: Blood Transfusion in Clinical Medicine , Oxford, England, Blackwell Scientific Publications, 1951;, p. 311.
52 +
Talbot, N. B.; Kerrigan, G. A.; Crawford, J. D.; Cochran, W., and Terry, M.:  Application of Homeostatic Principles to the Practice of Parenteral Fluid Therapy , New England J. Med. 252:856, 1955;.
53 +
Hill, F. S.: Practical Fluid Therapy in Pediatrics , Philadelphia and London, W. B. Saunders Company, 1954;, p. 10.
54 +
Bull, G. M.; Joekes, A. M., and Lowe, K. G.:  Conservative Treatment of Anuric Uremia , Lancet 2:229, 1949;.
55 +
Elkinton, J. R.; Clark, J. K.; Squires, R. D.; Bluemle, L. W., and Crosley, A. P., Jr.:  Treatment of Potassium Retention in Uremia with Cation Exchange Resin , Am. J. M. Sc. 220:547, 1950;.
56 +
Knowles, H. C., and Kaplan, S. A.:  Treatment of Hyperkalemia in Acute Renal Failure Using Exchange Resins , A. M. A. Arch. Int. Med. 92:189, 1953;.
57 +
Evans, B. W.; Hughes-Jones, N. C.; Milne, M. D., and Yellowlees, H.:  Ion Exchange Resins in the Treatment of Anuria , Lancet 2:791, 1953;.
58 +
Bessis, M.:  Use of Replacement Transfusion in Diseases Other Than Hemolytic Disease of Newborn , Blood 4:324, 1949;.
59 +
Snapper, I., and Schaefer, L. E.:  Treatment of 2 Patients with Hepatorenal Syndrome and Acute Renal Failure by Exsanguino Transfusion , Ann. Int. Med. 34:692, 1951;.
60 +
Dausset, J.:  Lower Nephron Nephrosis: Report of Treatment of 44 Patients by Repeated Replacement Tranfusions , Arch. Int. Med. 85:416, 1950;.
61 +
Goldbloom, R. B.:  Renal Failure with Extreme Hyperpotassemia: Its Treatment with Exchange Tranfusion , New England J. Med. 250: 717, 1954;.
62 +
Keefer, C. S., and Hewitt, W. L.: The Therapeutic Value of Streptomycin: A Study of 3000 Cases , Ann Arbor, Mich., Edwards Brothers, Inc., 1948;, p. 261.
63 +
Scribner, B. H.: Syllabus for the Course on Fluid and Electrolyte Balance, 1953, Fluid Research Fund, Seattle.

Figures

Tables

Interactive Graphics

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Osler, W.: Principles and Practice of Medicine , Ed. 2, New York, Appleton-Century-Crofts Company, 1895;, p. 763.
2 +
Oliver, J.; MacDowell, M., and Tracy, A.:  The Pathogenesis of Acute Renal Failure Associated with Traumatic and Toxic Injury , J. Clin. Invest. 30:1305, 1951;.
3 +
Peters, J. P.:  Oliguria and Anuria Due to Increased Intrarenal Pressure , Ann. Int. Med. 23: 221, 1945;.
4 +
Waugh, D.:  Acute Nephrosis: The Kidney of Acute Renal Failure , Am. J. M. Sc. 226:310, 1953;.
5 +
Swann, R. C., and Merrill, J. P.:  The Clinical Course of Acute Renal Failure , Medicine 32:215, 1953;.
6 +
Ponfick, E.: Berlin. klin. Wchnschr. 20:389, 1883;, cited by Waugh.4
7 +
Bywaters, E. G. L., and Beall, D.:  Crush Injuries with Impairment of Renal Function , Brit. M. J. 1:427, 1941;.
8 +
Lauson, H. D.; Bradley, S. E., and Cournand, A.:  The Renal Circulation in Shock , J. Clin. Invest. 23:381, 1944;.
9 +
Selkurt, E. E.:  Renal Blood Flow and Renal Clearance During Hemorrhagic Shock , Am. J. Physiol. 145:699, 1946;.
10 +
Lucke, B.:  Lower Nephron Nephrosis , Mil. Surgeon 99:371, 1946;.
11 +
Mallory, T. B.:  Hemoglobinuric Nephrosis in Traumatic Shock , Am. J. Clin. Path. 17:427, 1947;.
12 +
Kugel, V. H.:  Management of Acute Toxic Nephrosis , Am. J. Med. 3:188, 1947;.
13 +
Pratt, E. L.:  Treatment of Anuria , Am. J. Dis. Child . 74:730, 1947;.
14 +
Strauss, M. B.:  Acute Renal Insufficiency Due to Lower Nephron Nephrosis , New England J. Med. 239:693, 1948;.
15 +
Strauss, M. B., and Raisz, L. G.:  Treatment of Acute Renal Shutdown , A. M. A. Arch. Int. Med. 95:846, 1955;.
16 +
Wagner, J.:  Acute Tubular Necrosis with Anaemia , Great Ormond St. J. 7:66, 1954;.
17 +
Erganian, J. A., and Doval, J. A.:  Fatal Anuria Following Administration of Sulfonamides with Reference to Tubular Necrosis and Regeneration , J. Lab. & Clin. Med. 28:808, 1943;.
18 +
Press, E., and Kennerstein, M.:  Additional Manifestation of Sulphathiazole Toxicity: Non-Calculous Renal Insufficiency Following the Use of Sulphathiazole , Arch. Dis. Childhood 18:50, 1943;.
19 +
Higgins, T. T.; Williams, D. I., and Nash, D. F. E.: The Urology of Childhood , London, Butterworth & Co., Ltd., 1951;, p. 33.
20 +
Dintenfass, A.:  Allergic Manifestation to Sulfamerazine, with 2 Case Reports of Anuria in Children , Ohio M. J. 41:628, 1945;.
21 +
Riddell, H. I.:  The Lower Nephron Syndrome in Children , J. Urol. 65:177, 1951;.
22 +
Redish, J.; West, J. R.; Whitehead, B. W., and Chase, H.:  Abnormal Renal Tubular Back-Diffusion Following Anuria , J. Clin. Invest. 26: 1043, 1947;.
23 +
McClendon, S. J.:  Toxic Effects with Anuria from Single Injection of Bismuth Preparation , Am. J. Dis. Child . 61:339, 1941;.
24 +
Boyette, D. P.:  Bismuth Nephrosis with Anuria in Infant , J. Pediat. 28:493, 1946;.
25 +
Petersilge, C. L.:  Prolonged Anuria Following Single Injection of Bismuth Preparation , J. Pediat. 31:580, 1947;.
26 +
Hoffman, W. S., and Marshall, D.:  Management of Lower Nephron Nephrosis , Arch. Int. Med. 83:249, 1949;.
27 +
Karelitz, S., and Freedman, A. D.:  Hepatitis and Nephrosis Due to Soluble Bismuth , Pediatrics 8:772, 1951;.
28 +
Dunsky, I.:  Potassium Bromate Poisoning , Am. J. Dis. Child . 74:730, 1947;.
29 +
Thompson, H. C., and Westfall, S. W.:  Potassium Bromate Poisoning , J. Pediat. 34:362, 1949;.
30 +
Swan, H., and Gordon, H.:  Peritoneal Lavage in the Treatment of Anuria in Children , Pediatrics 4:586, 1949;.
31 +
Warren, S. A., and Gross, W. V., Jr.:  Clinical Recovery Following Prolonged Anuria in an Infant 2 Months of Age , Pediatrics 5:954, 1950;.
32 +
Kaplan, S. A., and Fomon, S. J.:  Function Recovery Pattern in Acute Renal Failure Following Ingestion of Mercuric Chloride , A. M. A. Am. J. Dis. Child . 85:633, 1953;.
33 +
Goodpaster, W. E.; Levenson, S. M.; Tagnow, H. J.; Lind, C. C., and Taylor, F. H. L.:  Clinical and Pathological Study of the Kidney in Patients with Thermal Burns , Surg. Gynec. & Obst. 82:652, 1946;.
34 +
Martineau, P. C., and Hartman, F. W.:  Renal Lesions in Extensive Cutaneous Burn , J. A. M. A. 134:429, 1947;.
35 +
Carter, F. H.; Aoyama, S.; Mercer, R. D., and Kolff, W. J.:  Hemodialysis in Children: Report of 5 Cases , J. Pediat. 51:125, 1957;.
36 +
Wahle, G. H., Jr., and Muirhead, E. E.:  Bilateral Renal Cortical Necrosis in a Child Associated with an Incompatible Blood Transfusion , Texas J. Med. 49:770, 1953;.
37 +
Buerger, W. R.; Lambert, E. C., and Maitland, B. A. A.:  Peritoneal Irrigation: Method of Treatment of Acute Renal Failure in an Infant , Am. J. Dis. Child . 78:237, 1949;.
38 +
Zuelzer, W. W.; Charles, S.; Kurnetz, R.; Newton, W. A., Jr., and Fallon, R.:  Circulatory Diseases of the Kidneys in Infancy and Childhood , A. M. A. Am. J. Dis. Child. 81:1, 1951;.
39 +
Mateer, F. M.; Greenman, L., and Danowski, T. S.:  Hemodialysis of the Uremic Child , A. M. A. Am. J. Dis. Child. 89:645, 1955;.
40 +
Schwartz, R.; Tomsovic, E. J., and Schwartz, I. I.:  Hyperpotassemia and Body Water Disturbance in an Anuric Child , Pediatrics 7:516, 1951;.
41 +
Jonsson, B.:  Lower Nephron Nephrosis in Asphyxia Neonatorum , Acta paediat. 40:401, 1951;.
42 +
Meroney, W. H., and Herndon, R. F.:  Management of Acute Renal Insufficiency , J. A. M. A. 155:877, 1954;.
43 +
Rubin, M. I., and Calcagno, P. L.:  Renal Disease in Infants and Children , Pediatrics 17: 781, 1956;.
44 +
Whitelaw, W.:  Case of Anuria Lasting 25 Days: Recovery , Lancet 2:460, 1877;.
45 +
Tamaki, H. T., and Whitman, M. A.:  Hemorrhagic Papillary Necrosis of the Kidney , J. A. M. A. 150:1304, 1952;.
46 +
Keitzer, W. A.:  Acute Uremia , J. Urol. 73: 920, 1955;.
47 +
Teschan, P. E.; Post, R. S.; Smith, L. H., Jr.; Abernathy, R. S.; Davis, J. H.; Gray, D. M.; Howard, J. M.; Johnson, K. E.; Klopp, E.; Mundy, R. L.; O'Meara, M. P., and Rush, B. F., Jr.:  Post-Traumatic Renal Insufficiency in Military Casualties: I. Clinical Characteristics , Am. J. Med. 18: 172, 1955;.
48 +
Luetscher, J. A., Jr., and Blackman, S. S., Jr.:  Severe Injury to Kidneys and Brain Following Sulfathiazole Administration: High Serum Sodium and Chloride Levels and Persistent Cerebral Damage , Ann. Int. Med. 23:741, 1943;.
49 +
Barclay, T. L., and Wallace, A. B.:  Management of Burns: II. Fluid Replacement in Burned Patients , Lancet 1:98, 1954;.
50 +
Hall, A. D., and Luetscher, J. A., Jr.:  Renal Disease , New England J. Med. 239:621, 1948;.
51 +
Mollison, P. L.: Blood Transfusion in Clinical Medicine , Oxford, England, Blackwell Scientific Publications, 1951;, p. 311.
52 +
Talbot, N. B.; Kerrigan, G. A.; Crawford, J. D.; Cochran, W., and Terry, M.:  Application of Homeostatic Principles to the Practice of Parenteral Fluid Therapy , New England J. Med. 252:856, 1955;.
53 +
Hill, F. S.: Practical Fluid Therapy in Pediatrics , Philadelphia and London, W. B. Saunders Company, 1954;, p. 10.
54 +
Bull, G. M.; Joekes, A. M., and Lowe, K. G.:  Conservative Treatment of Anuric Uremia , Lancet 2:229, 1949;.
55 +
Elkinton, J. R.; Clark, J. K.; Squires, R. D.; Bluemle, L. W., and Crosley, A. P., Jr.:  Treatment of Potassium Retention in Uremia with Cation Exchange Resin , Am. J. M. Sc. 220:547, 1950;.
56 +
Knowles, H. C., and Kaplan, S. A.:  Treatment of Hyperkalemia in Acute Renal Failure Using Exchange Resins , A. M. A. Arch. Int. Med. 92:189, 1953;.
57 +
Evans, B. W.; Hughes-Jones, N. C.; Milne, M. D., and Yellowlees, H.:  Ion Exchange Resins in the Treatment of Anuria , Lancet 2:791, 1953;.
58 +
Bessis, M.:  Use of Replacement Transfusion in Diseases Other Than Hemolytic Disease of Newborn , Blood 4:324, 1949;.
59 +
Snapper, I., and Schaefer, L. E.:  Treatment of 2 Patients with Hepatorenal Syndrome and Acute Renal Failure by Exsanguino Transfusion , Ann. Int. Med. 34:692, 1951;.
60 +
Dausset, J.:  Lower Nephron Nephrosis: Report of Treatment of 44 Patients by Repeated Replacement Tranfusions , Arch. Int. Med. 85:416, 1950;.
61 +
Goldbloom, R. B.:  Renal Failure with Extreme Hyperpotassemia: Its Treatment with Exchange Tranfusion , New England J. Med. 250: 717, 1954;.
62 +
Keefer, C. S., and Hewitt, W. L.: The Therapeutic Value of Streptomycin: A Study of 3000 Cases , Ann Arbor, Mich., Edwards Brothers, Inc., 1948;, p. 261.
63 +
Scribner, B. H.: Syllabus for the Course on Fluid and Electrolyte Balance, 1953, Fluid Research Fund, Seattle.

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