[Hemolytic-uremic syndrome in Chile: clinical features, evolution and prognostic factors].
BACKGROUND
Hemolytic-uremic syndrome (HUS) is characterized by acute renal failure, microangiopathic hemolytic anemia and thrombocytopenia.


OBJECTIVE
To describe the characteristics of patients with the diagnosis of HUS in Chile, and to identify the most reliable early predictors of morbidity and mortality.


METHODS
The clinical records of patients with HUS aged less than 15 years, attended between January 1990 and December 2003 in 15 hospitals, were reviewed. Demographic, clinical, biochemical, hematological parameters, morbidity and mortality were analyzed.


RESULTS
A cohort of 587 patients aged 2 to 8 years, 48% males, was analyzed. Ninety two percent had diarrhea. At the moment of diagnosis, anuria was observed in 39% of the patients, hypertension in 45% and seizures in 17%. Forty two percent required renal replacement therapy (RRT) and peritoneal dialysis was used in the majority of cases (78%). The most frequently isolated etiological agent was Escherichia coli. Mortality rate was 2.9% in the acute phase of the disease and there was a positive correlation between mortality and anuria, seizures, white blood cell count (WCC)>20.000/mm3 and requirements of renal replacement therapy (p<0.05). Twelve percent of patients evolved to chronic renal failure and the risk factors during the acute phase were the need for renal replacement therapy, anuria, WCC>20.000/mm3, seizures and hypertension.


CONCLUSIONS
The present study emphasizes important clinical and epidemiological aspects of HUS in a Chilean pediatric population.
Zambrano O
Pedro
P
Unidad de Nefrología, Hospital de Niños Dr. Exequiel González Cortés, Santiago, Chile. phzambrano@hotmail.com
Delucchi B
Angela
A
Cavagnaro S
Felipe
F
Hevia J
Pilar
P
Rosati M
María Pía
MP
Lagos R
Elizabeth
E
Nazal Ch
Vilma
V
González C
Claudia
C
Barrera B
Patricia
P
Alvarez L
Enrique
E
Pinto S
Viola
V
Salas del C
Paulina
P
Cano Sch
Francisco
F
Contreras M
Angélica
A
Galanti de la P
Mónica
M
Gana A
Juan Cristóbal
JC
Zamorano C
Julio
J
Espinoza B
Amelia
A
Dreves R
Patricia
P
Pereira M
Jaime
J
Bidegain S
Antonia
A
Pasten P
Ema
E
Yáñez P
Leticia
L
Cerda F
Verónica
V
Rodríguez S
Eugenio
E
Aglony I
Marlene
M
Gutiérrez I
Elisa
E
Salas P
Francisca
F
Figueroa Y
Sonia
S
Valenzuela A
Marcela
M
Grandy H
Jean
J
Guerra A
Boris
B
Lapadula A
Michelangelo
M
Reutter de la M
Paula
P
Gallardo T
Vivian
V
Maldonado S
Douglas
D
Azócar P
Marta
M
Cavada Ch
Gabriel
G
D058186:Acute Kidney Injury / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D001002:Anuria / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data; D002675:Child, Preschool; D002677:Chile / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006463:Hemolytic-Uremic Syndrome / Q000150:complications* / Q000401:mortality / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D011379:Prognosis; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors