Duration of oliguria and anuria as predictors of chronic renal-related sequelae in post-diarrheal hemolytic uremic syndrome
| Autor: | Robert S, Oakes, Justin K, Kirkham, Justin K, Kirkhamm, Raoul D, Nelson, Richard L, Siegler |
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| Rok vydání: | 2007 |
| Předmět: |
Nephrology
Adult Diarrhea Male medicine.medical_specialty Pediatrics Adolescent Oliguria Renal function urologic and male genital diseases Anuria Predictive Value of Tests Internal medicine medicine Humans Registries Renal Insufficiency Chronic Child Escherichia coli Infections Proteinuria Shiga-Toxigenic Escherichia coli business.industry Incidence (epidemiology) Incidence Acute kidney injury Infant Retrospective cohort study Acute Kidney Injury medicine.disease Prognosis female genital diseases and pregnancy complications Surgery Logistic Models Child Preschool Pediatrics Perinatology and Child Health Hemolytic-Uremic Syndrome Multivariate Analysis Female medicine.symptom business Follow-Up Studies |
| Zdroj: | Pediatric nephrology (Berlin, Germany). 23(8) |
| ISSN: | 0931-041X |
| Popis: | Prior long-term retrospective studies have described renal sequelae in 25-50% of postdiarrheal hemolytic uremic syndrome (HUS) survivors, but the ability to predict the likelihood of chronic renal-related sequelae at the time of hospital discharge is limited. We surveyed 357 children in our HUS registry who survived an acute episode of post diarrheal HUS (D+HUS) and were without end-stage renal disease (ESRD) at the time of hospital discharge. Of the 357 patients surveyed, 159 had at least 1 year (mean 8.75 years) of follow-up. Of these, 90 individuals were identified as having had at least 1 day of oliguria, with 69 individuals having had at least 1 day of anuria. The incidences of renal-related sequelae [proteinuria, low glomerular filtration rate (GFR), and hypertension] were determined among experimental groups based on oliguria and anuria duration. One or more sequelae (e.g. proteinuria, low GFR, hypertension) was seen in 25 (36.2%) of those who had no recorded oliguria and 34 (37.8%) of those with no recorded anuria. The prevalence of chronic sequelae increased markedly in those with more than 5 days of anuria or 10 days of oliguria, with anuria being a better predictor than oliguria of most related sequelae. A particularly high incidence of hypertension was seen in patients with > 10 days of anuria (55.6%) in comparison with those with no anuria (8.9%) [odds ratio (OR) 12.8; 95% confidence interval (CI) 2.9-57.5]. Patients with > 10 days of anuria were also at substantially increased risk for low GFR and proteinuria (OR 35.2; 95% CI 5.1-240.5). These findings may help identify children who need periodic and extended follow-up after hospital discharge. |
| Databáze: | OpenAIRE |
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