Acute Renal Failure in a Child with Idiopathic Nephritic Syndrome (A Case Study)

Introduction: Acute renal failure is an uncommon complication of idiopathic nephritic syndrome in children. Renal failure could be secondary to causes such as sever hypovolumia, acute tubular necrosis, interstitial nephritis, bilateral renal vein thrombosis, acute pyelonephritis and rapid progression of original glomerular disease. It may be idiopathic if the underlying cause is undetermined. Although idiopathic acute renal failure (IARF) has been described previously, this study presents histopathologic finding and outcome of IARF in a child with idiopathic nephritic syndrome.

Case Report: An 11 year - old girl with corticosteroid and cyclophosphamid resistant nephritic syndrome presented with acute renal failure. She was on cyclosporine one year ago but had relative response to cyclosporine, which presented with irreversible acute renal failure.

Discussion: IARF is a rare complication in children with idiopathic minimal change nephritic syndrome. The exact pathophysology of IARF is not well understood. Possible proposed explanations included severe interstitial oedema, peritonitis, hypovolemia, tubular obstruction, and altered glomerular permeability. In this case there is no justifiable cause for acute renal failure and IARF should be considered as a diagnostic possibility in this patient.