Comportamiento del fallo renal agudo en ni？os con sepsis grave

introduction: the aim of present research was to determine the risk factor associated with the acute renal failure (arf) in a group of children with severe sepsis seen between january, 2004 and december, 2008. methods: an analytical and observational study was conducted in a sample including 171 patients. there were two groups: the study-group with 138 patients with septic shock status or organ multiple dysfunctions (omd) and arf, and a control-group including 133 children in similar sepsis status but with a normal renal function. the medical records were reviewed and we took into account the epidemiological variables, risk factors of arf and case course. results: the arf incidence was of 22,2% and although it significantly decreased during the three first years of study, mortality was of 42,1%, mainly in the omd (89,5%). there was a dependence between the renal insufficiency and the no-appropriate response to the fluid-therapy (51,2%), the hemodynamic instability for over 24 hours (46,5%), myocardial dysfunction (43,3%) and the use of nephrotoxin drugs (42,8%). conclusions: the non-appropriate diuretic response to fluid-therapy, the hemodynamic instability during more the 24 hours, the myocardial dysfunction and the use of nephrotoxin drugs increased the arf risk in cases of severe sepsis, which to double the mortality in relation to patients maintaining their renal function. however, prevention of severe forms of sepsis and its suitable treatment decrease the arf incidence.