目的　探讨儿童肾功能衰竭的病因、临床和病理特点。方法　回顾分析 1996年 1月至 2 0 0 2年 6月诊治的 2 1例儿童肾功能衰竭病历资料。结果　①急性肾功能衰竭 12例 ,其中肾小球疾病引起者 8例 ,肾外因素所致者 4例 ;肾活检 6例 ,呈多种病理改变 ,伴不同程度细胞新月体形成。选择利尿、血液透析、甲基泼尼松龙冲击等治疗 ,10例肾功能有不同程度恢复 ,2例死亡。②慢性肾功能衰竭 9例 ,其中先天性肾脏疾病所致 2例 ,肾小球疾病所致 7例 ;肾活检 3例 ,病理呈系膜增生性肾小球肾炎、膜增殖性肾小球肾炎伴肾小球硬化或增生硬化。预后较差。结论　①急性肾功能衰竭治疗关键在于早期明确病因 ,应采用肾活检明确病理类型以指导治疗。②慢性肾功能衰竭缺乏特异性临床表现 ,易漏诊和误诊 ,应定期进行尿液常规检查 ,对肾脏疾病要进行有效治疗 ,防止慢性肾功能衰竭发生。 Objective To investigate the etiology, clinical and pathological features of children with renal failure. Methods The data of 21 cases of children with renal failure who were diagnosed and treated from January 1996 to June 2002 were retrospectively analyzed. Results 12 cases of acute renal failure, including glomerular disease caused by 8 cases, 4 cases caused by extra-renal factors; 6 cases of renal biopsy showed a variety of pathological changes with varying degrees of crescent formation of cells. Choose diuretic, hemodialysis, methylprednisolone impact treatment, 10 cases of renal function with varying degrees of recovery, 2 patients died. ② Chronic renal failure in 9 cases, of which 2 cases caused by congenital kidney disease, glomerular disease caused by 7 cases; 3 cases of renal biopsy, pathological mesangial proliferative glomerulonephritis, proliferative glomerulonephritis With glomerular sclerosis or proliferative sclerosis. Poor prognosis. Conclusion ① The key to the treatment of acute renal failure lies in the early clear cause. Kidney biopsy should be used to confirm the pathological type to guide the treatment. ② chronic renal failure, the lack of specific clinical manifestations, easy misdiagnosis and misdiagnosis, routine urine tests should be carried out on the effective treatment of renal disease to prevent the occurrence of chronic renal failure.