title: Dehydration at admission increased the need for dialysis in hemolytic uremic syndrome children.
abstract: BACKGROUND
  Oligoanuric forms of postdiarrheal hemolytic uremic syndrome (D+ HUS) usually have more severe acute stage and higher risk of chronic sequelae than nonoligoanuric forms. During the diarrheal phase, gastrointestinal losses could lead to dehydration with pre-renal injury enhancing the risk of oligoanuric D+ HUS. Furthermore, it had been shown that intravenous volume expansion during the prodromal phase could decrease the frequency of oligoanuric renal failure. Thus, we performed this retrospective study to determine whether dehydration on admission is associated with increased need for dialysis in D+ HUS patients.
  
  
  METHODS
  Data from 137 children was reviewed, which were divided into two groups according to their hydration status at admission: normohydrated (n = 86) and dehydrated (n = 51). Laboratory parameters of the dehydrated patients reflected expected deteriorations (higher urea, higher hematocrit and lower sodium, bicarbonate, and pH) than normohydrated ones. Likewise, the dehydrated group had a higher rate of vomiting and need for dialysis (70.6 versus 40.7 %, p = 0.0007).
  
  
  CONCLUSIONS
  Our data suggests that dehydration at hospital admission might represent a concomitant factor aggravating the intrinsic renal disease in D+ HUS patients increasing the need for dialysis. Therefore, the early recognition of patients at risk of D+ HUS is encouraged to guarantee a well-hydrated status.
authors.affiliation: Nephrology Unit, Hospital General de Niños Pedro de Elizalde, Montes de Oca 40, 1270, Ciudad Autónoma de Buenos Aires, Argentina. abalestracci@yahoo.com.ar
authors.forename: Alejandro
authors.initials: A
authors.lastname: Balestracci
authors.forename: Sandra Mariel
authors.initials: SM
authors.lastname: Martin
authors.forename: Ismael
authors.initials: I
authors.lastname: Toledo
authors.forename: Caupolican
authors.initials: C
authors.lastname: Alvarado
authors.forename: Raquel Eva
authors.initials: RE
authors.lastname: Wainsztein
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003681:Dehydration / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000150:complications*; D006801:Humans; D007223:Infant; D008297:Male; D006435:Renal Dialysis; D012189:Retrospective Studies