Introduction: Acute kidney failure (ARF) is a condition in which there is sudden reduction in renal function which results in the inability to excrete metabolic wastes like creatinine, urea and to maintain fluid, electrolytes. The immediate causes of ARF are a decrease in the volumetric rate of blood flow, acute damage to the glomeruli with loss of glomerular capillaries, damage to the tubules of the nephrons or impaired outflow of urine due to obstruction. Depending on this, there are the following forms of ARF: prerenal (70%), parenchymal (25%), obstructive (5%). Treatment of ARF always begins with conservative therapy. In the absence of effect in pediatric practice, preference is given to peritoneal dialysis, and if it is impossible to conduct – hemodialysis.

Aim. Analysis of methods and effectiveness of ARF treatment in pediatric practice.

Materials and methods: During 2017-2021, 7 children with a diagnosis of ARF were treated in the somatic department of the Sumy pediatric Hospital. Three children had symptoms of ARF as a result of congenital or acquired hemolytic anemia, two children suffered from poisoning (rat poison and an unknown substance), the other 2 children had kidney damage due to severe infections (bilateral pneumonia and acute intestinal infection).

Results: From the beginning of the development of the first symptoms, all children received symptomatic treatment in the form of forced diuresis, anticoagulant therapy, antibiotic therapy, alkaline therapy in case of hemolytic anemia and rat poisoning. Conservative therapy has been effective in 3 children with various types of hemolytic anemias. These patients had a history of hemolytic crises and were treated at the first symptoms of hemolysis. All other 4 children were admitted late with clinic of acute poisoning and severe infections. The mother of a child with pneumonia refused treatment for 2 weeks, which led to the development of sepsis and acute kidney damage. 2 children received repeated sessions of peritoneal dialysis, and the 2 others  – hemodialysis. After long-term treatment, all patients recovered, but are under the supervision of a nephrologist.

Conclusions: Conservative treatment of ARF is more effective with timely initiation of therapy, especially in patients with hemolytic crises. At late treatment of patients with severe infections and poisonings, conservative treatment is ineffective and requires additional methods of efferent therapy in the form of peritoneal or hemodialysis.