Objective. The acute-stage mortality and morbidity of acute renal failure (ARF) is well documented, but there are few long-term follow-up studies in children with ARF, particularly from developing countries. The aim of this study was to look at the spectrum of ARF on presentation at a tertiary centre in Kolkata, India, with subsequent 10 years of follow-up. Subjects and methods. All cases of ARF between the ages of 1 month and 10 years presenting between April and September 1996 were included.

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... e did exclude children with any known renal abnormality. The study group was subsequently monitored for renal survival and mortality until 10 years post-ARF episode. Results. A total of 37 (n = 37) cases were enrolled. Glomerulonephritis and snakebite were the two most common aetiologies (n = 17 and n = 9). The acute mortality was 35% (n = 13), and it was significantly associated with peak creatinine and presence of multiple organ failure (P < 0.05). The outcome at 6 months could be assessed for 92% (n = 22) of acute survivors and at 10 years for 67% (n = 16). The children that were traced showed in 32% (n = 7) at 6 months and 38% (n = 6) at 10 years, respectively, at least one of the four (abnormal creatinine, hypertension, haematuria and proteinuria) abnormal renal parameters. Snakebite, acute-stage peak creatinine and duration of oliguria were significantly associated with adverse long-term outcome (P < 0.05). Conclusion. We found that nearly 25% (n = 6) of the survivors of an acute episode of renal failure had renal morbidity after 10 years, a percentage significant enough for these children to need long-term follow-up.