Absence of renal sequelae after childhood Escherichia coli O157:H7 gastroenteritis
| Autor: | Garg, A.X., Clark, W.F., Salvadori, M., Thiessen-Philbrook, H.R., Matsell, D., for the Walkerton Health Study Investigators |
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| Rok vydání: | 2006 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Time Factors Urinary system 030232 urology & nephrology Renal function Escherichia coli O157 Asymptomatic 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Risk Factors Internal medicine cohort study Albuminuria Humans Medicine 030212 general & internal medicine Child Escherichia coli Infections risk Kidney Creatinine water supply business.industry Incidence medicine.disease Gastroenteritis 3. Good health Surgery Blood pressure medicine.anatomical_structure chemistry Child Preschool Hemolytic-Uremic Syndrome Hypertension Disease Progression renal Female Kidney Diseases Microalbuminuria medicine.symptom business Glomerular Filtration Rate |
| Zdroj: | Kidney International. 70:807-812 |
| ISSN: | 0085-2538 |
| DOI: | 10.1038/sj.ki.5001645 |
| Popis: | Although a quarter of children who survive diarrhea-associated hemolytic uremic syndrome develop long-term renal sequelae, the prognosis of acute, self-limited Escherichia coli O157:H7 gastroenteritis has never been previously studied. Four years after a drinking water outbreak of E. coli O157:H7, we examined the risk of high blood pressure (95th percentile expected for age, sex, and height), reduced kidney function, and microalbuminuria among previously healthy children and adolescents. Of the 951 participants, 313 were asymptomatic during the outbreak, 305 had moderate symptoms of acute gastroenteritis, and 333 had severe symptoms that necessitated medical attention. An additional 23 children who developed hemolytic uremic syndrome during the outbreak were excluded from this analysis. There were no differences in mean systolic blood pressure between those who had no, moderate, or severe symptoms of acute gastroenteritis during the outbreak (109, 110, and 107 mm Hg). Similarly, there were no group differences in diastolic blood pressure, estimated glomerular filtration rate, or random urine albumin to creatinine ratio (P ranged from 0.14 to 0.52), or in the adjusted relative risk of high blood pressure, a glomerular filtration rate80 ml/min per 1.73 m(2), or microalbuminuria (P ranged from 0.23 to 0.89). Patients who presented to medical attention with gastroenteritis during this E. coli O157:H7 outbreak had an absence of renal sequelae 4 years later. With no existing data to support screening after self-limited E. coli O157:H7 gastroenteritis, we recommend that only those children who develop recognized features of hemolytic uremic syndrome be followed for long-term renal health. |
| Databáze: | OpenAIRE |
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