Prognostic significance of certain factors in the haemolytic-uraemic syndrome

Korniszewska, J; Gura, C; Welc-Dobies, J; Lewicki, Z

doi:10.1007/bf00857656

Cited by 12 publications

(9 citation statements)

References 14 publications

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“…In our study the proportion of HUS patients developing CRF was higher when the disease had an atypical com pared to a typical (postenteropathic) onset. This finding is in accordance with the experience from other centers [15,[22][23]. Age was not a significant predictor of outcome in our study; however the youngest children (< 1 year) pre sented the lowest recovery rate, possibly related to their high incidence of severe CNS involvement.…”

Section: Discussionsupporting

confidence: 81%

“…Severe arterial hypertension in the acute phase of HUS may also have a prognostic significance as reported earlier [22]. We could further confirm that patients with a predomi nant arterial involvement in renal tissue are associated with a worse prognosis compared to those with isolated glome rular changes [10], In contrast to other investigators [19] we observed no relationship between the outcome and the total leukocyte count.…”

Section: Discussioncontrasting

confidence: 56%

“…Age was not a significant predictor of outcome in our study; however the youngest children (< 1 year) pre sented the lowest recovery rate, possibly related to their high incidence of severe CNS involvement. In other studies young age was associated with either a worse [5,7,22,24,25], better [10,15,16] or similar [19] prognosis.…”

Section: Discussionmentioning

confidence: 99%

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Outcome and Prognostic Determinants in the Hemolytic Uremic Syndrome of Children

Tönshoff

Sammet

Sanden

et al. 1994

Nephron

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The late outcome in 89 children with the hemolytic-uremic syndrome (HUS) oberved from 1971 to 1988 was analyzed up to 17 years after onset in relationship to various clinical and pathologic features at the onset of the disease. In the first 3 months after onset (acute phase) 69% of all children needed dialysis therapy. Fifteen children died, 9 during the acute phase and 6 subsequently. All surviving patients except 7 were reexamined and divided into five prognostic categories: recovery, residual renal symptoms with normal kidney function, moderate renal insufficiency, preterminal chronic renal failure (CRF) and end-stage renal disease (ESRD). The rate of recovery calculated by the life table method increased from 35% after 10 years in 1971-1979 to 68% in 1980-1988 (p < 0.001); it was lower in infants than in older children (44 vs. 63%; nonsignificant). Children with an atypical HUS experienced more often preterminal CRF, ESRD or death than those with a typical (postenteropathic) form (33 vs. 17%; p < 0.05). If oliguria lasted < 7 days, 74% of patients recovered after 10 years versus 13% in the case of oliguria > 14 days or anuria > 7 days (p < 0.0005). The rate of recovery was also significantly smaller with the duration of dialysis treatment > 7 days, central nervous system involvement and requirement for antihypertensive therapy. In the entire series 7 patients developed preterminal CRF and 5 ESRD. Of 27 cases serially followed for 5-10 years after onset, a stable course was noted in 16, a subsequent improvement in 8 and deterioration in 3 leading to ESRD in 2. In conclusion, the study demonstrates a high incidence of chronic kidney disease in patients who have suffered from HUS. Late deterioration of renal function after apparent recovery underlines the need for continuing follow-up examinations for at least 10 years.

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Section: Discussionsupporting

confidence: 81%

Section: Discussioncontrasting

confidence: 56%

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Outcome and Prognostic Determinants in the Hemolytic Uremic Syndrome of Children

Tönshoff

Sammet

Sanden

et al. 1994

Nephron

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“…Most recent series report an acute mortality rate of between 3% and 16% [3 -9], although in other series it has been as high as 30% [15]. This may reflect different management as well as variability in the severity of the disease.…”

Section: Discussionmentioning

confidence: 91%

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

Spizzirri

Rahman

Bibiloni

et al. 1997

Pediatric Nephrology

122

111

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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.

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“…However, an analysis of their data reveals that after 15,23 and 24 days of oligu ria, respectively, follow-up GFR was reduced in each of the 3 patients and that proteinuria was present in 2 of the patients. Sieniawska et al [16] reported that the duration of anuria was not a statistically significant prognostic fac tor. In their study, all 73 children were anuric, and 36% of these children died.…”

Section: Oliguria or Anuria Are Reported To Occur In 41-100% Of Childmentioning

confidence: 99%

Relationship of the Recovery in the Glomerular Filtration Rate to the Duration of Anuria in Diarrhea-Associated Hemolytic Uremic Syndrome

Robson

Leung²,

Brant³

1993

Am J Nephrol

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The relationship of the duration of anuria to the recovery in glomerular filtration rate (GFR) was studied in 71 children with diarrhea-associated hemolytic uremic syndrome. A significant relationship was found, and regression analysis revealed that y = 114.61 – 5.68 x, where y is predicted GFR (ml/min/ 1.73 m²) and x is the square root of the duration of anuria in days. The presence of hypertension or proteinuria on follow-up was significantly related to the duration of anuria (p = 0.005 and p = 0.002, respectively).

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Prognostic significance of certain factors in the haemolytic-uraemic syndrome

Cited by 12 publications

References 14 publications

Outcome and Prognostic Determinants in the Hemolytic Uremic Syndrome of Children

Outcome and Prognostic Determinants in the Hemolytic Uremic Syndrome of Children

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

Relationship of the Recovery in the Glomerular Filtration Rate to the Duration of Anuria in Diarrhea-Associated Hemolytic Uremic Syndrome

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