Post renal causes of ARF are unusual in children. Boys with posterior urethral valves may present with ARF in the neonatal period. With routine antenatal screening, the majority of these children are identified prior to delivery. There can be varying degress of renal insufficiency and because of tubular damage there can be severe problems with salt and water wasting.
The other situation where obstruction may cause ARF is in children with a single kidney. This may suffer pelviureteric or vesicoureteric obstruction or obstruction from a calculus. Children with ARF, particularly when obstruction is a possibility, should therefore have an urgent ultrasound examination to exclude this correctable problem.
Web links:
Web page describing the procedure of inserting a nephrostomy tube.