title: Two different therapeutic regimes in patients with sequelae of hemolytic-uremic syndrome.
abstract: Renal disease is the most important long-term complication of hemolytic-uremic syndrome (HUS). A comparative study of renal function was carried out in two groups of patients. Group 1 included 19 children followed for a median of 11 years, 1960-1980, with a low-sodium diet, antihypertensive drugs, and a restricted protein intake in the end stage of renal disease. Group 2 included 26 children treated for a median of 9 years, 1988-2002, on a low-sodium diet, early restriction of protein intake according to recommendations, and angiotensin converting enzyme inhibitors (ACEi). Long-term renal function was assessed by the inverse of the plasma creatinine concentration (1/[Cr]) over time. Linear regression lines were fitted to individual values of 1/[Cr] for each child. Regression coefficients of children in group 1 were all negative, ranging from -0.031 to -0.00043; 7 were significantly different from zero, indicating a linear fall in renal function over time. In contrast, children from group 2 had 11 negative slopes (only 1 significant) and 15 positive slopes, ranging from 0.17893 to -0.3899. Fisher's exact test showed that group 1 had significantly more children with negative slopes than group 2. This comparatively better long-term outcome of renal function in children under contemporary treatment was probably associated with early restriction of protein and use of ACEi.
authors.affiliation: Nephrology Service, Garrahan Hospital, Combate de los Pozos 1881, 1245 Buenos Aires, Argentina.
authors.forename: María Gracia
authors.initials: MG
authors.lastname: Caletti
authors.forename: Horacio
authors.initials: H
authors.lastname: Lejarraga
authors.forename: Diana
authors.initials: D
authors.lastname: Kelmansky
authors.forename: Mabel
authors.initials: M
authors.lastname: Missoni
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D018753:Diet, Protein-Restricted; D004039:Diet, Sodium-Restricted; D018450:Disease Progression; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000628:therapy*; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000517:prevention & control; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents