title: Adult haemolytic and uraemic syndrome: causes and prognostic factors in the last decade.
abstract: BACKGROUND
  Haemolytic uraemic syndrome (HUS) is a rare and severe disease of various aetiologies in adults. The effect of fresh frozen plasma (FFP) infusion in adults suffering from HUS is not well defined. The aim of this retrospective study was to analyse the causes of HUS in adults admitted in a single renal intensive care unit (ICU) and to determine the life and renal prognosis factors, while most patients (78%) received FFP infusion.
  
  
  METHODS
  We recorded clinical, biological, and histological data of 55 adults admitted in our renal ICU for HUS between 1990 and 1998, 49 of them having had a renal biopsy. By stepwise logistic regression analysis, we examined the parameters that were associated with the in-hospital mortality and renal function at discharge.
  
  
  RESULTS
  HUS complicated different diseases in 40 patients (HIV infection n=18, nephropathies n=10, allotransplantation n=7, malignant diseases n=5) and appeared as a primary in 15 patients. Factors influencing the in-hospital mortality were positive HIV serology (odds ratio (OR) >20, P=0.0002) and requirement for haemodialysis (OR >35, P=0.004). A pre-existing nephropathy was a bad prognosis factor for renal function (OR >99, P=0.02), while fever was associated with better renal prognosis (OR=1/10, P=0.033).
  
  
  CONCLUSIONS
  HUS in adults remains a severe disease, with a high mortality rate in HIV patients and in those who required haemodialysis. However, as compared with previous studies, we observed an improvement in renal outcome, particularly in patients with primary HUS, suggesting a beneficial effect of FFP infusion, at least in these forms.
authors.affiliation: Service de Néphrologie A et Association Claude Bernard, Hôpital Tenon, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Tostivint
authors.forename: Béatrice
authors.initials: B
authors.lastname: Mougenot
authors.forename: Antoine
authors.initials: A
authors.lastname: Flahault
authors.forename: Cécile
authors.initials: C
authors.lastname: Vigneau
authors.forename: Marie-Alyette
authors.initials: MA
authors.lastname: Costa
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Haymann
authors.forename: Jean-Daniel
authors.initials: JD
authors.lastname: Sraer
authors.forename: Eric
authors.initials: E
authors.lastname: Rondeau
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis; D013997:Time Factors