ACUTE RENAL FAILURE:

Objective: To find out the various causes of acute renal failure (ARF) and its out come in our settingof tertiary Care Hospital in rural areas. Design: A retrospective Study. Setting: Nephro-urology department ChandkaMedical College teaching hospital Larkana. Period: From March 1998 to March 2005. Patients & Methods: Reviewof 294 patients of acute renal failure admitted in Nephro-urology department Chandka Medical College teachinghospital Larkana. Detailed history, physical examination and laboratory data of 294 consecutive patients of acute renalfailure were analyzed. Result: 294 patients were included in this study. Among them149 (51.7%) were in the youngerage group (less than 40 years) with dominance of males (1.61 to 1.00 male to female ratio). Major cause of ARF waspre renal, seen in 172 (66.6%) patients, 70 (23.8%) of all cases of acute renal failure had gynecological and obstetricalback ground. Other causes C.V.A in 24 (9.3%), HHD in 14(4.5%). Glomerulonephritis in 22(8.5%),and obstructiveuropathy in 16(6.2%). 92 Patients (31.3%) improved on conservative treatment,166(56.5%) needed dialysis and36(12.2%) left against medical advice. Conclusion: This data reveals that pre renal element is the single mostimportant 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 perinatal care and good therapeutic measures substantially bring down the incidence of acute renal failure. 12.2% patientsleft against medical advice due to heavy expenses on the treatment and needs NGOs and Government support fortreatment of poor patients.