Abstract
Hemolytic uremic syndrome (HUS) is one of the main causes of acute renal failure in the Chilean pediatric population. To report the features of patients with HUS, admitted to the pediatric ward of a clinical hospital. Retrospective review of medical records of patients admitted with the diagnosis of HUS between 1995 and 2002. During the period, 58 patients were admitted with the diagnosis of HUS but only 43 (age range 1 month to 6 years, 22 females) had complete medical records for review. Ninety five percent presented with prodromic diarrhea, mainly dysenteric. Antibiotics were administered to 70%, in the previous days. Acute renal replacement, mainly peritoneal dialysis, was required in 40%. The clinical signs and laboratory parameters that correlated better with the indication for dialysis were anuria, hypertension, initial and permanently high serum creatinine and blood urea nitrogen. Four patients with blood urea nitrogen over 100 mg/dl but without anuria or hyperkalemia, were treated conservatively, and experienced an uneventful course (permissive azotemia). Hospital stay was almost 3 times greater in dialyzed than in non dialyzed children. No deaths related to HUS were reported in the study period. In an average follow up of 54 months, 11.6% of the patients developed chronic renal failure of diverse magnitude. Despite the fact that our study group behaved clinically similar to published HUS patients in other series, no mortality was observed in a retrospective analysis of patients with this disease.
Highlights
Hemolytic uremic syndrome (HUS) is one of the main causes of acute renal failure in the Chilean pediatric population
De los 41 pacientes, sólo 17 (41%) tuvieron coprocultivos positivos, 15 (88,2%) para Escherichia coli enteropatógena, 1 para Shigella dysenteriae y 1 para Citrobacter freundii
En relación a la etiología del síndrome hemolítico urémico (SHU) D+, el bajo porcentaje de positividad de nuestros coprocultivos (41%) puede estar relacionado al frecuente uso de antibióticos (70%), indicados por personal de salud previo a la hospitalización
Summary
Hemolytic uremic syndrome (HUS) is one of the main causes of acute renal failure in the Chilean pediatric population. Aim: To report the features of patients with HUS, admitted to the pediatric ward of a clinical hospital. La principal etiología del SHU es la infección gastrointestinal por cepas de Escherichia coli productoras de toxinas del tipo Shiga (verotoxinas), que da origen a un cuadro diarreico prodrómico (SHU-D+), generalmente de características hemorrágicas o disentéricas. La presentación del síndrome no precedido por un cuadro diarreico prodrómico (SHU-D-) es menos frecuente, suele afectar a niños de mayor edad y adultos y se ha descrito asociado a mayor morbimortalidad inicial y a largo plazo[11,12]. La mortalidad de 50% publicada por los primeros reportes[1], ha disminuido drásticamente a alrededor de 5% desde la utilización de diálisis peritoneal como tratamiento de la insuficiencia renal aguda. El objetivo del presente trabajo es evaluar la experiencia clínica en relación con pacientes hospitalizados, en un Servicio de Pediatría, con el diagnóstico de SHU, durante un período de 8 años, con énfasis en las características evolutivas, decisiones terapéuticas y evolución a corto y mediano plazo
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
