Diarrhea-associated hemolytic uremic syndrome in southern Alberta: A long-term single-centre experience.
BACKGROUND
Reports of long-term incidence trends of endemic diarrhea-associated hemolytic uremic syndrome (D+HUS) are few and inconclusive.


OBJECTIVE
To define and analyze the incidence and outcomes of D+HUS over a period of approximately 25 years in a highly endemic region of southern Alberta.


METHODS
Annual incidence rates of confirmed cases of D+HUS were compared between two 12-year periods (1980 to 1992 and 1994 to 2006). Differences in therapies used, and some short- and long-term complications observed were also compared between the two periods.


RESULTS
The absolute yearly number of D+HUS cases was highly variable. The comparison between the 1980 to 1992, and 1994 to 2006 periods demonstrated a modest 8.8% decrease in the total number of cases. The population-based average annual incidence rates were not significantly different between the two time periods (3.33 cases versus 2.58 cases per 100,000 population per year, respectively; P=0.30). Only supportive care measures were used in the latter period. A mortality rate of lower than 1% in the latter period was one of the lowest ever reported for a large cohort of D+HUS patients.


CONCLUSIONS
The present long-term retrospective study of D+HUS in a highly endemic area documented a modest decrease in the absolute number of cases but no difference in the average annual incidence over an extended period of time.
Division of Nephrology, Alberta Children's Hospital, Department of Pediatrics, Faculty of Medicine, University of Calgary, Calgary, Alberta.
Silviu
S
Grisaru
Julian P
JP
Midgley
Lorraine A
LA
Hamiwka
Andrew W
AW
Wade
Susan M
SM
Samuel