[Changing clinical course of hemolytic uremic syndrome in children].
An incidence of hemolytic-uraemic syndrome as a cause of the acute renal failure in childhood, its early survival rate and long-term sequela quences were compared in the 1970s, 1980s, and 1990s in the same geographical area. 196 children with HUS were treated between 1972-1999. 94% had a typical D+ HUS. The majority were of patients severely ill with 87% requiring peritoneal dialysis of an average 14 days duration. The children were grouped into three 9-year periods for comparison (1972-1980, 1981-1989, 1990-1999). 105 patients were followed for 2-27 years (mean 1 years). An incidence of HUS as a cause of ARF in childhood ranged from 58% and 50% in the 1970s and 1980s to 30% in the past decade. With time survival rate has improved dramatically over the years from 80% and 75% to 97% in the 1990s. Deo spite better short term outcome the late consequences of HUS are serious. The longer the follow-up, the greater percentage of patients with severe outcome. At last follow-up only 32% children showed full recovery. 33% are on renal replacement therapy or have impaired renal function. The severity of the initial lesions to the kidney measured by the duration of anuria is a marker of poor late prognosis. With improving early outcome the clinical significance of HUS is focusing on its severe long-term consequences.
Zurowska
A
A
Klinika Nefrologii Dzieciecej Akademii Medycznej w Gdańsku.
Gockowska
Z
Z
Czarniak
P
P
Marczak
E
E
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006463:Hemolytic-Uremic Syndrome / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D015994:Incidence; D051437:Renal Insufficiency / Q000209:etiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate