According to Medline Plus, the kidneys, or renal system, help control water levels and eliminate wastes through urine. They also help regulate blood pressure, red blood cell production and the levels of calcium and minerals. The United States National Library of Medicine reports that kidney failure results in the inability of the kidneys to maintain fluid and electrolyte balance. The most common causes of pediatric renal failure are asphyxia, drug toxicity, septicemia and genitorenal anomalies.
Asphyxia
Asphyxia can cause pediatric renal failure. According to the Encyclopedia of Children's Health, asphyxia is respiratory failure that occurs in the newborn. This results from inadequate intake of oxygen, leading to hypoxia and a lowering of the oxygen supply to the main organs and tissues. According to a 2008 study published in the Clinical Journal of the American Society of Nephrology, the kidneys of neonates are particularly susceptible to hypoperfusion, a decreased blood flow through the kidney, because of the physiologic characteristics of neonatal kidneys. The American Society of Pediatric Nephrology mentions that birth asphyxia results in redistribution of blood flow towards the brain and heart and away from the kidneys. As kidneys are very sensitive to decreased oxygen, this may lead to irreversible acute tubular necrosis, renal vein thrombosis and renal failure and may even result in permanent renal damage.
Low Birth Weight
According to a 2008 study published in the New England Journal of Medicine, newborn infants, especially those who are born preterm and have low birth weight, are more susceptible to renal failure. The reasons behind this are developmental immaturity that limits the function of the immature kidney, hemodynamic changes, such as hypotension, and increased risk of hypovolemia, caused by large water losses.
Birth Defects
According to a 2008 study published in the International Web Journal for Medical Professionals, the pediatric kidney has a very low glomerular filtration rate (GFR). Although sufficient for growth and development under normal conditions, the low GFR limits kidney function adaptation to internal and external stress. According to Medline Plus, the second major category of neonatal kidney failure comprises birth malformations in the urinary system, which can lower the GFR.
Sepsis
According to Medline Plus, sepsis can lead to renal failure in children. The American Society of Nephrology reports that sepsis is a serious infection that involves the spread of germs throughout the body's blood and tissues. It can be caused by viruses, fungi, parasites or bacteria. Sepsis neonatorum is a serious blood bacterial infection in an infant less than 4 weeks of age. Medline Plus states that sepsis can operate through a variety of mechanisms in producing renal failure, including shock, hemorrhage and cardiac failure.
Drug Toxicity
According to a 2008 study published in the Pediatric Nephrology Journal, drugs that interfere with the structural development or physiologic function of the neonatal kidney can lead to renal failure. Antihypertensive drugs such as angiotensin converting enzyme inhibitors and nonsteroidal anti-inflammatory drugs, when used in the second half of pregnancy, can cause neonatal kidney failure by decreasing GFR. Antibiotics and diuretics may contribute to renal insufficiency, according to the United States National Library of Medicine.
References
- "International Web Journal for Medical Professionals"; Acute Renal Failure in the Newborn (Part I): Classification and Causes; R. Alexander; November 2008
- "The New England Journal of Medicine"; ACE Inhibitors and Congenital Anomalies; J.M.Friedman; June 2006
- "Clinical Journal of the American Society of Nephrology", Potential Interventions in Sepsis-related Acute Kidney Injury; R.Claudio; January 2008
- Medline Plus: Kidney Failure
- "Pediatric Nephrology Journal"; Nephrotoxicity as a Cause of Acute Kidney Injury in Children; L.Patzer; December 2008
