[Continuous hemofiltration in patients with abdominal complications of hemolytic uremic syndrome].
BACKGROUND
Close to one half of patients with hemolytic uremic syndrome (HUS) will require a dialytic therapy, mainly peritoneal dialysis (PD). In some cases, PD may have relative or absolute contraindications, usually when HUS is associated to severe intraabdominal complications.


OBJECTIVE
To report the results of continuous hemofiltration use, in children with abdominal complications of HUS.


METHODS
Retrospective review of the files of 40 patients that were admitted to our pediatric unit with HUS, since 1995. Six children had relevant intra-abdominal complications and were treated with continuous hemofiltration (CHF). Four additional children, with similar HUS related complications and treated with CHF before 1995, were included in the analysis.


RESULTS
The age of the patients ranged from 5 to 66 months old. An arterio-venous CHF was performed in four and veno-venous CHF in six children. The duration of CHF was 93.2 hours in average. Adequate control of volemia was achieved in every patient; diafiltration with peritoneal dialysis solution was added in five patients, to improve azotemia. Four patients had complications related to the vascular access or the anticoagulation procedure. The procedure was terminated due to improvement of diuresis in five cases, transfer to PD in four and a cardiorespiratory arrest in one. Only one patient developed a chronic renal failure during the follow up.


CONCLUSIONS
CHF is an effective and safe alternative of acute renal replacement therapy in the management of renal failure in pediatric cases with HUS, aggravated with abdominal complications.
Cavagnaro
Felipe
F
Departamento de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Lira 44, Santiago, Chile. fcavagna@med.puc.cl
Vogel
Andrea
A
Ronco
Ricardo
R
Rodríguez
José Ignacio
JI
D058186:Acute Kidney Injury / Q000209:etiology*; D002675:Child, Preschool; D005260:Female; D006440:Hemofiltration / Q000009:adverse effects* / Q000379:methods / Q000592:standards; D006463:Hemolytic-Uremic Syndrome / Q000150:complications* / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies