Childhood hemolytic uremic syndrome in Argentina : long-term follow-up and prognostic features

From January 1968 to December 1984, 312 infants and children with hemolytic uremic syndrome were admitted to our unit; 8 patients died (2.5%) during the acute phase; 118 children were followed as outpatients at yearly intervals for at least 10 years (mean follow-up 13 years, range 10-19.8 years). Fo...

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Bibliographic Details
Published in:Pediatric nephrology (Berlin, West) West), 1997-04, Vol.11 (2), p.156-160
Main Authors: SPIZZIRRI, F. D, RAHMAN, R. C, BIBILONI, N, RUSCASSO, J. D, AMOREO, O. R
Format: Article
Language:English
Subjects:
Anuria - etiology
Argentina - epidemiology
Biological and medical sciences
Child
Child, Preschool
Female
Follow-Up Studies
Hemolytic-Uremic Syndrome - diagnosis
Hemolytic-Uremic Syndrome - mortality
Hemolytic-Uremic Syndrome - physiopathology
Humans
Infant
Kidney Function Tests
Male
Medical sciences
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Prognosis
Proteinuria - etiology
Renal Dialysis
Renal failure
Risk Factors
Survival
Treatment Outcome
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Summary:From January 1968 to December 1984, 312 infants and children with hemolytic uremic syndrome were admitted to our unit; 8 patients died (2.5%) during the acute phase; 118 children were followed as outpatients at yearly intervals for at least 10 years (mean follow-up 13 years, range 10-19.8 years). Four evolution patterns at the end of the follow-up were defined: group 1, complete recovery, 74 (62.7%); group 2, proteinuria with/without hypertension, 21 (17.7%); group 3, reduced creatinine clearance, often in conjunction with proteinuria and hypertension, 19 (16.1%); group 4, end-stage renal failure, 4 (3.4%). We investigated the association between several variables of the acute stage and the long-term evolution. Most non-anuric patients recovered completely (92.5%), while 38.4% of those with 1-10 days and 69.2% of those with 11 or more days of anuria had chronic renal sequelae. Similar results were found when analyzing the requirement for peritoneal dialysis. Of the patients with proteinuria at the 1-year control, 86% had renal abnormalities at the end of the follow-up. In our experience, although the final outcome was not predictable in every instance, the severity of acute renal failure-as determined by the days of anuria- and the presence of proteinuria 1 year after the acute phase were the most useful prognostic indicators.
ISSN:0931-041X
1432-198X
DOI:10.1007/s004670050248