Adult haemolytic and uraemic syndrome: causes and prognostic factors in the last decade
| Autor: | Cécile Vigneau, Marie-Alyette Costa, Jean-Daniel Sraer, Antoine Flahault, Isabelle Tostivint, Jean-Philippe Haymann, Béatrice Mougenot, Eric Rondeau |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Renal function Blood Pressure urologic and male genital diseases Nephropathy law.invention Renal Dialysis law Internal medicine medicine Humans Aged Aged 80 and over Acquired Immunodeficiency Syndrome Transplantation medicine.diagnostic_test business.industry Mortality rate Odds ratio Middle Aged Prognosis medicine.disease Kidney Transplantation Intensive care unit Surgery Nephrology Kidney Failure Chronic/epidemiology/etiology Hemolytic-Uremic Syndrome/*diagnosis/pathology/physiopathology Kidney Transplantation/statistics & numerical data Hemolytic-Uremic Syndrome Acquired Immunodeficiency Syndrome/complications Kidney Failure Chronic Female Renal biopsy Fresh frozen plasma business Kidney disease |
| Zdroj: | Nephrology, Dialysis, Transplantation, Vol. 17, No 7 (2002) pp. 1228-34 |
| ISSN: | 1460-2385 0931-0509 |
| DOI: | 10.1093/ndt/17.7.1228 |
| Popis: | Background. Haemolytic uraemic syndrome (HUS) is a rare and severe disease of various aetiologies in adults. The effect of fresh frozen plasma (FFP) infusion in adults suffering from HUS is not well defined. The aim of this retrospective study was to analyse the causes of HUS in adults admitted in a single renal intensive care unit (ICU) and to determine the life and renal prognosis factors, while most patients (78%) received FFP infusion. Methods. We recorded clinical, biological, and histological data of 55 adults admitted in our renal ICU for HUS between 1990 and 1998. 49 of them having had a renal biopsy. By stepwise logistic regression analysis, we examined the parameters that were associated with the in-hospital mortality and renal function at discharge. Results. HUS complicated different diseases in 40 patients (HIV infection n = 18, nephropathies n = 10, allotransplantation n = 7, malignant diseases n = 5) and appeared as a primary in 15 patients. Factors influencing the in-hospital mortality were positive HIV serology (odds ratio (OR) >20, P=0.0002) and requirement for haemodialysis (OR >35, P = 0.004). A pre-existing nephropathy was a bad prognosis factor for renal function (OR >99, P = 0.02), while fever was associated with better renal prognosis (OR = 1 10, P = 0.033). Conclusions. HUS in adults remains a severe disease, with a high mortality rate in HIV patients and in those who required haemodialysis. However. as compared with previous studies, we observed an improvement in renal outcome, particularly in patients with primary HUS, suggesting a beneficial effect of FFP infusion, at least in these forms. |
| Databáze: | OpenAIRE |
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