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Risk Factors for Short- and Long-Term Outcomes in Children With STEC-HUS/D+ HUS: A Single-Center Experience

Judith Sebestyen VanSickle1,2, Tarak Srivastava1,2, Uri S Alon1,2

  • 1The Children's Mercy Hospitals and Clinics, Kansas City, MO, USA.

Global Pediatric Health
|December 15, 2018
PubMed

Insights

Children with Shiga toxin-producing Escherichia coli (STEC)-HUS require dialysis if female, oliguric, or with high hemoglobin. Hemodialysis increases neurological risks, and prolonged dialysis raises chronic kidney disease risk.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Hemolytic uremic syndrome (HUS) is a significant cause of acute kidney injury in children.
  • Shiga toxin-producing Escherichia coli (STEC)-HUS and other diarrhea-positive (D+ HUS) are common forms requiring medical attention.

Purpose of the Study:

  • To identify risk factors for short-term complications in pediatric STEC-HUS and D+ HUS.
  • To determine predictors of long-term chronic kidney disease (CKD) outcomes in these patients.

Main Methods:

  • Retrospective chart review of 58 pediatric patients with STEC-HUS or D+ HUS.
  • Analysis of patient demographics, clinical parameters, and treatment modalities (dialysis type, duration).

Main Results:

  • 56.9% of patients required dialysis, associated with female gender, oliguria, and higher admission hemoglobin.
  • Neurological complications occurred in 5 dialyzed patients, more frequent with hemodialysis (HD).
  • 8.6% of patients developed CKD, linked to HD, dialysis >10 days, and higher admission hemoglobin.

Conclusions:

  • Female gender, low urine output, and high admission hemoglobin predict dialysis need in pediatric HUS.
  • Hemodialysis increases the risk of neurological complications; prolonged dialysis (>10 days) is a risk factor for CKD development.

Keywords:
CKDCNS complicationsD+ HUSHGB levelSTEC-HUSdialysis

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