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). 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.
Spizzirri
F D
FD
Renal Unit, Hospital de Niños Sor María Ludovica, La Plata, Argentina.
Rahman
R C
RC
Bibiloni
N
N
Ruscasso
J D
JD
Amoreo
O R
OR
D001002:Anuria / Q000209:etiology; D001118:Argentina / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006463:Hemolytic-Uremic Syndrome / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007677:Kidney Function Tests; D008297:Male; D011379:Prognosis; D011507:Proteinuria / Q000209:etiology; D006435:Renal Dialysis; D012307:Risk Factors; D013534:Survival; D016896:Treatment Outcome