Аңдатпа
INTRODUCTION: Typical hemolytic uremic syndrome (HUS) is one of the most common causes of acute kidney injury (AKI) in children (1) and may have significant sequelae (eg, neurological complications or chronic kidney disease (CKD)) for patients (2,3). Our hospital is the tertiary referral center that admits pediatric patients with AKI required dialysis from all over the country. The goal of the study was to identify potential risk factors for short-term outcomes in children with typical HUS who required dialysis. METHODS: This retrospective study included data from 77 pediatric patients < 18 years of age with typical HUS who were admitted to the National Research Center for Maternal and Child Health, Astana, Kazakhstan between 2008 and 2018 and received dialysis treatment. We analyzed the effect of the following characteristics: complete blood count on the day of the first dialysis (hemoglobin < 6.5g/dL, leukocytes > 15 x 103 mL, platelets < 80 x 103 mL), anuria/oliguria day of starting dialysis, length of anuria > 10 days, length of dialysis > 20 days and presence of neurological complications on death and development of CKD Stage 3 – 5 over 90 days following introduction of renal replacement therapy (RRT). Association with outcomes were assessed using logistic regression and adjusted for age. RESULTS: The median age of our cohort was 1,6 (IQR 0.95-2.4) with boys accounted for 53% (n=41). 5 (6.5%) patients died and 7 patients (9%) developed CKD Stage 3 – 5 with 3 of them receiving permanent dialysis by the 90th day after initiation of RRT due to HUS. Patients who needed RRT more than 20 days had a high risk of development of CKD in the following three months (OR: 18,73, 95% CI: 2.09-167.52). We also found that patients with neurological complications after initiation of dialysis therapy showed a higher risk of death (OR: 12.87, 95% CI: 1.34-123,95). Hemoglobin < 6.5g/dL, leukocytes > 15 x 103 mL, platelets < 80 x 103 mL, anuria/oliguria day of starting dialysis, length of anuria > 10 days were not associated with death or development of short-term CKD. CONCLUSIONS: Dialysis duration > 20 days and presence of neurological complications were the most important risk factors for poor short-term outcomes (development of CKD Stage 3-5 and death respectively) in our study. References: 1. Siegler RL. The hemolytic uremic syndrome. Pediatr Clin North Am. 1995;42;1505-1529. 2. Loos S, Aulbert W, Hoppe B et. al. Intermediate Follow-up of Pediatric Patients With Hemolytic Uremic Syndrome During the 2011 Outbreak Caused by E. coli O104:H4. Clin Infect Dis. 2017;64(12):1637. 3. Siegler RL, Pavia AT, Christofferson RD, Milligan MK. A 20-year population-based study of postdiarrheal hemolytic uremic syndrome in Utah. Pediatrics. 1994;94(1):35.