Prognostic factors in the hemolytic-uremic syndrome
| Autor: | Mierzewski P, Marczak E, Schramm K, Uszycka-Karcz M, Gockowska Z, Zurowska A |
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| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Gastroenterology Peritoneal dialysis chemistry.chemical_compound Risk Factors Internal medicine Medicine Humans Life Tables Dialysis Acidosis Coma Creatinine business.industry Mortality rate Discriminant Analysis Infant medicine.disease Prognosis Surgery chemistry Pediatrics Perinatology and Child Health Hemolytic-Uremic Syndrome Kidney Failure Chronic Anuria Female medicine.symptom business Hypervolemia Follow-Up Studies |
| Zdroj: | Scopus-Elsevier Publons |
| Popis: | During 1972–1986 142 children were treated. Most of them were infants (73%). Prodromal symptoms lasted 1-16 days and usually involved the gastrointestinal tract. Severe gastrointestinal symptoms had poor prognostic significance. Convulsions, coma and hypertension which did not resolve after correction of hypervolemia were also features of poor prognosis. Laboratory findings at onset such as hyperkaliemia exceeding 7 mmol/L and acidosis with bicarbonate levels below 12 mmol/L were associated with a worse prognosis. 80% of children required peritoneal dialysis. Delay in the starting of dialysis after 5th day of anuria was a further poor prognostic factor. The total mortality rate reached 25.4%. This high mortality rate was due to the severe clinical course, to the late diagnosis and delay in dialysis treatment. The greatest risk of death existed in the first 3 weeks from onset. They were followed up from several months to 14 years. Twelve children developed chronic renal failure (11,3%). Discriminant analysis revealed the following factors to be associated with the development of chronic renal failure: delay indialysis, onset of disease in spring/summer months, older age, duration of acute renal failure, older age, duration of hemolysis and peak level of creatinine. |
| Databáze: | OpenAIRE |
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