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Prognostic factors in the hemolytic-uremic syndrome
M Uszycka-Karcz1, E Marczak, P Mierzewski
1Pediatric Clinic of Nephrology, Gdańsk, Poland.
Child Nephrology and Urology
|January 1, 1988
Summary
Hemolytic-uremic syndrome (HUS) in children has a 25.4% mortality rate, with infants most affected. Key fatal outcome predictors include severe GI symptoms, coma, and delayed dialysis.
Area of Science:
- Pediatrics
- Nephrology
- Critical Care Medicine
Background:
- Hemolytic-uremic syndrome (HUS) is a serious condition primarily affecting infants.
- A significant mortality rate has been associated with HUS, necessitating identification of risk factors.
Purpose of the Study:
- To identify risk factors associated with fatal outcomes in pediatric Hemolytic-uremic syndrome (HUS).
- To analyze long-term sequelae in HUS survivors.
Main Methods:
- Retrospective analysis of 142 children treated for HUS between 1972 and 1986.
- Computerized analysis of clinical data to determine predictors of mortality.
Main Results:
- The overall mortality rate for HUS was 25.4%, with infants comprising 73% of cases.
- Identified risk factors for fatal outcomes included severe gastrointestinal symptoms, coma, convulsions, malignant hypertension, prolonged symptoms (>7 days), hyperkalemia (>7 mmol/l), acidosis (<15 mmol/l bicarbonate), delayed dialysis (>5 days), and long transport distances (>100 km).
- The highest risk of death occurred within the first 3 weeks of onset.
Conclusions:
- Early identification of risk factors is crucial for managing pediatric HUS.
- Twelve of 106 survivors developed chronic renal failure, highlighting the need for long-term follow-up.