Recovery of renal function after seven weeks of anuric acute kidney injury in a 2 year old Nigerian child

Abstract

Background: Acute Kidney Injury (AKI) is rapid decline in kidney function with rising creatinine and/or reduced urinary output. The urinary manifestation ranges from oliguria to anuria. Although the anuric AKI tends to have prolonged course, most are expected to recover within two to three weeks. We present the case of a 2 year old Nigerian girl who against our expectation had recovery of renal functions after seven weeks of anuria.

Case report: A two year old girl who was referred with 14 days history of reduction in passage of urine and 12 days history of generalized body swelling. The reduction in passage of urine was preceded by a week history of generalized, pustular and pruritic skin lesion. On admission she had generalized oedema, moderate ascites and BP  was 100/60mmHg (prehypertension).  She made only 0.05mls/kg/hour in the first 48 hours and remained anuric until end of 5th week on admission (7th week since  the onset of symptoms). The child had a cumulative 18 days of peritoneal dialysis over the 5 weeks. Bedside urinalysis showed protein (3+) and blood (4+). Serum creatinine declined from 582µmol/l (6.58mg/dl) to 46µmol/l (0.52mg/dl) at discharge while urea also reduced from 33.5 mmol/l to 4.8mmol/l.

Conclusion: A child with anuric AKI may require PD for as long as seven weeks before renal functions fully recover.

Key words: AKI, anuria, recover, seven weeks, renal function