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Risk factors for poor renal prognosis in children with hemolytic uremic syndrome
- Source :
- Pediatric nephrology (Berlin, Germany). 18(12)
- Publication Year :
- 2003
-
Abstract
- Many factors have been proposed as predictors of poor renal prognosis in children with hemolytic uremic syndrome (HUS), but their role is still controversial. Our aim was to detect the most reliable early predictors of poor renal prognosis to promptly identify children at major risk of bad outcome who could eventually benefit from early specific treatments, such as plasmapheresis. Prognostic factors identifiable at onset of HUS were evaluated by survival analysis and a proportional hazard model. These included age at onset, prodromal diarrhea (D), leukocyte count, central nervous system (CNS) involvement, and evidence of Shiga toxin-producing Escherichia coli (STEC) infection. Three hundred and eighty-seven HUS cases were reported; 276 were investigated for STEC infection and 189 (68%) proved positive. Age at onset, leukocyte count, and CNS involvement were not associated with the time to recovery. Absence of prodromal D and lack of evidence of STEC infection were independently associated with a poor renal prognosis; only 34% of patients D(-)STEC(- )recovered normal renal function compared with 65%-76% of D(+)STEC(+), D(+)STEC(-) and D(-)STEC(+ )patients. In conclusion, absence of both D and evidence of STEC infection are needed to identify patients with HUS and worst prognosis, while D(-) but STEC(+) patients have a significantly better prognosis.
- Subjects :
- Nephrology
Diarrhea
Male
medicine.medical_specialty
Atypical hemolytic uremic syndrome
Adolescent
medicine.medical_treatment
Gastroenterology
Shiga Toxin
Cohort Studies
Leukocyte Count
fluids and secretions
Shiga toxin-producing Escherichia coli
Central Nervous System Diseases
Risk Factors
Internal medicine
medicine
Humans
Risk factor
Age of Onset
Child
Escherichia coli Infections
Proportional Hazards Models
Prognostic factor
business.industry
Proportional hazards model
Infant
Classification
medicine.disease
Prognosis
Long-term outcome
Survival Analysis
Hemolytic urenic syndrome
Treatment Outcome
Italy
Child, Preschool
Pediatrics, Perinatology and Child Health
Immunology
Hemolytic-Uremic Syndrome
Plasmapheresis
Female
medicine.symptom
Age of onset
business
Kidney disease
Subjects
Details
- ISSN :
- 0931041X
- Volume :
- 18
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Pediatric nephrology (Berlin, Germany)
- Accession number :
- edsair.doi.dedup.....f342f5df275154598f3770ce8f194509