Related Experiment Video
Updated: Feb 26, 2026
A Mouse Model to Evaluate the Long-Term Structural and Functional Outcomes after the Reversal of Prolonged Unilateral Ureteric Obstruction
Published on: July 18, 2025
Long-term follow-up of children with typical hemolytic uremic syndrome
Birutė Pundzienė1, Diana Dobilienė1, Rimantė Čerkauskienė2
1Department of Children Diseases, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Insights
Long-term sequelae in children with typical hemolytic uremic syndrome (HUS) include increasing rates of hypertension and proteinuria after 10 years. Younger children (<1 year) are more susceptible to developing hypertension post-HUS.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
- Internal Medicine
Background:
- Typical hemolytic uremic syndrome (HUS) is a serious condition in children.
- Understanding the long-term health consequences of HUS is crucial for patient management.
Purpose of the Study:
- To investigate the association between the acute phase of typical HUS and the development of late-emerging sequelae in children.
- To evaluate the long-term renal function, hypertension, and proteinuria in children following an acute HUS episode.
Main Methods:
- Retrospective analysis of data from 62 children with typical HUS during the acute phase.
- Evaluation of 33 children at 1-, 5-, and ≥10-year follow-ups for hypertension, proteinuria, and renal function.
- Assessment of factors such as age, duration of anuria/oliguria, and renal replacement therapy.
Main Results:
- In the acute phase, 75.8% had hypertension, 85.5% had proteinuria, and 100% had renal dysfunction.
- At 10-year follow-up, hypertension prevalence was 24.2% and proteinuria 33.3%, with new onset in 6.1%.
- Renal injury persisted in over one-third of cases at 10 years, more common with acute hypertension.
Conclusions:
- Hypertension and proteinuria initially decrease but increase after 10 years post-HUS.
- Children under 1 year at HUS onset are at higher risk for developing hypertension.
- Persistent renal dysfunction is common, particularly if hypertension was present during the acute phase.
Objective:
The aim of the study was to determine the associations of the acute period course with late-emerging sequelae in children with typical hemolytic uremic syndrome (HUS).
Materials And Methods:
The data of 62 children with typical HUS during the acute phase were retrospectively analyzed by age, sex, duration of anuria/oliguria, method and duration of renal replacement therapy, proteinuria, hypertension, and renal function. The data of 33 children at 10-year follow-up after the onset of the disease were evaluated for changes in hypertension, proteinuria, and renal function.
Results:
In the acute phase of the disease (n=62), hypertension was documented in 75.8% of the children; proteinuria, in 85.5%; and renal dysfunction, in 100%. At 10 years after the onset of the disease (n=33), hypertension was documented in 12.1%, 6.1%, and 24.2% at 1-, 5-, and ≥10-year follow-ups, respectively, and more often in children aged <1 year at the onset of the disease. Proteinuria was found in 15.2%, 9.1%, and 33.3% of the patients, respectively. After ≥10 years, hypertension developed for the first time in 6.1% of the patients. Renal injury of varying degrees was seen in 15.2% of the children at the 1-year follow-up, and after ≥10 years the proportion increased to 33.3%.
Conclusions:
At 10 years after the acute phase of typical HUS in children, the prevalence of hypertension and proteinuria at 1- and 5-year follow-ups decreased, but after 10 years it started to increase. As much as 6.1% of the children developed hypertension or proteinuria for the first time at 10 years. Hypertension was documented more frequently in children who were younger than <1 year at the onset of the disease. Renal dysfunction after 5 and 10 years remained in more than one-third of cases, and it was observed more often if hypertension was documented at the acute period.
Related Concept Videos
01:29Acute Kidney Injury III: Clinical Manifestations
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:16Kidney Transplant III: Nursing Management
01:18Endocarditis III: Medical Management
01:30Continuous Renal Replacement Therapy
01:24Chronic Kidney Disease II: Clinical Manifestations