TY - CHAP M1 - Book, Section TI - Renal Failure A1 - Srivaths, Poyyapakkam R. A2 - Goday, Praveen S. A2 - Mehta, Nilesh M. Y1 - 2015 N1 - T2 - Pediatric Critical Care Nutrition AB - The term “acute renal failure” (ARF) for alteration in kidney function in an acute setting was first introduced by Smith1 to define changes in kidney function due to traumatic injuries. Since the kidney's physiological role is the excretion of water-soluble solutes and urine production, changes in these parameters are often included in the definition of ARF. However, since the magnitude of changes is not uniformly defined, there is a large ascertainment bias when epidemiology of ARF is examined. For example, in a pediatric intensive care unit (PICU) study that defined ARF as doubling of serum creatinine (Cr), the incidence of ARF in all children admitted to the PICU was reported as 4.5%. However, in another PICU study that defined ARF as elevation of serum Cr to 1.5 times the normal value, the incidence of ARF was 82% in children with severe illness .2,3 This discrepancy led to the adoption of a consensus definition of ARF by the Acute Dialysis Quality Initiative. The objective was to arrive at a definition of ARF that uses standardized terminology and includes a broad range of acute impairment of renal function. This definition is referred by the acronym RIFLE,4 which stands for risk, injury, failure, loss of function, and end-stage renal disease (ESRD). These criteria have been modified in children to account for normal variations in serum Cr with somatic growth, referred to as pRIFLE (Table 14-1).3 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1105179353 ER -