ACUTE RENAL FAILURE:

AN EXPERIENCE AT NEPHRO-UROLOGY DEPARTMENT CHANDKA MEDICAL COLLEGE HOSPITAL LARKANA

Abstract

Objective: To find out the various causes of acute renal failure (ARF) and its out come in our setting
of tertiary Care Hospital in rural areas. Design: A retrospective Study. Setting: Nephro-urology department Chandka
Medical College teaching hospital Larkana. Period: From March 1998 to March 2005. Patients & Methods: Review
of 294 patients of acute renal failure admitted in Nephro-urology department Chandka Medical College teaching
hospital Larkana. Detailed history, physical examination and laboratory data of 294 consecutive patients of acute renal
failure were analyzed. Result: 294 patients were included in this study. Among them149 (51.7%) were in the younger
age group (less than 40 years) with dominance of males (1.61 to 1.00 male to female ratio). Major cause of ARF was
pre renal, seen in 172 (66.6%) patients, 70 (23.8%) of all cases of acute renal failure had gynecological and obstetrical
back ground. Other causes C.V.A in 24 (9.3%), HHD in 14(4.5%). Glomerulonephritis in 22(8.5%),and obstructive
uropathy in 16(6.2%). 92 Patients (31.3%) improved on conservative treatment,166(56.5%) needed dialysis and
36(12.2%) left against medical advice. Conclusion: This data reveals that pre renal element is the single most
important cause of acute renal failure, in which commonest cause was pregnancy related ARF followed by C.V.A,HHD,
glomerulonephrits and obstructive urophathy. Early indentification, referral treatment of pre renal factors, good peri
natal care and good therapeutic measures substantially bring down the incidence of acute renal failure. 12.2% patients
left against medical advice due to heavy expenses on the treatment and needs NGOs and Government support for
treatment of poor patients.