title: Dehydration upon admission is a risk factor for incomplete recovery of renal function in children with haemolytic uremic syndrome.
abstract: BACKGROUND
  Haemolytic uremic syndrome (HUS) is the most common cause of acute renal failure and the second leading cause of chronic renal failure in children. The factors that affect incomplete renal function recovery prior to hospital admission are poorly understood.
  
  
  OBJECTIVE
  To analyse the risk factors that determine incomplete recovery of renal function prior to hospitalisation in children with HUS.
  
  
  METHODS
  A retrospective case-control study.
  
  
  METHODS
  age, sex, duration of diarrhoea, bloody stools, vomiting, fever, dehydration, previous use of antibiotics, and incomplete recovery of renal function (proteinuria, hypertension, reduced creatinine clearance, and chronic renal failure during follow-up). Patients of both sexes under 15 years of age were included.
  
  
  RESULTS
  Of 36 patients, 23 were males (65.3%; 95%CI: 45.8 to 80.9), with an average age of 2.5 ± 1.4 years. Twenty-one patients required dialysis (58%; 95% CI: 40.8 to 75.8), and 13 (36.1%; 95% CI: 19.0 to 53.1) did not recover renal function. In the bivariate model, the only significant risk factor was dehydration (defined as weight loss >5%) [(OR: 5.3; 95% CI: 1.4 to 12.3; P=.0220]. In the multivariate analysis (Cox multiple regression), only dehydration was marginally significant (HR: 95.823; 95% CI: 93.175 to 109.948; P=.085).
  
  
  CONCLUSIONS
  Our data suggest that dehydration prior to admission may be a factor that increases the risk of incomplete recovery of renal function during long-term follow-up in children who develop HUS D+. Consequently, in patients with diarrhoea who are at risk of HUS, dehydration should be strongly avoided during outpatient care to preserve long-term renal function. These results must be confirmed by larger prospective studies.
authors: Área de Pediatría y Neonatología, Hospital Privado, Unidad Académica, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
authors: José M
authors: JM
authors: Ojeda
authors: Isolda
authors: I
authors: Kohout
authors: Eduardo
authors: E
authors: Cuestas
mesh_terms: D016022:Case-Control Studies; D003681:Dehydration / Q000209:etiology*; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000150:complications* / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D010343:Patient Admission; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors