Long-term prognosis of hemolytic uremic syndrome and effective renal plasma flow View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1999-09

AUTHORS

Dieter Hüseman, Jutta Gellermann, Ilka Vollmer, Iris Ohde, Siegmar Devaux, Jochen H. H. Ehrich, G. Filler

ABSTRACT

The long-term prognosis of diarrhea-associated hemolytic uremic syndrome (D+ HUS) was evaluated in a cohort of 127 of 149 children who had survived the acute phase. Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were estimated by serial 51Cr-EDTA and 123iodine-hippurate clearances. All children had acute renal failure during the initial phase and 74% of patients were dialyzed. During the 1st year, mean GFR and ERPF increased continuously until a plateau was reached. In the 2nd year after the diagnosis of HUS, GFR was below 80 and ERPF below 515 ml/min per 1.73 m2 in 16% and 47% of patients, respectively. At the end of a median follow-up of 5.0 (range 2.0–13.2) years, the proportion of children with renal sequelae such as proteinuria ≥300 mg/l, hypertension, or a GFR <80 ml/min per 1.73 m2 was 23%. Anuria of more than 7 days’ duration and hypertension during the acute phase were statistically significant risk factors for an unfavorable outcome. A reduced ERPF in the 2nd year was found in 93% of patients with sequelae. Mean filtration fraction (SD) in these patients was 0.26 (±0.07) versus 0.19 (±0.05) in patients without sequelae (P<0.0001). These data suggest that loss of nephrons during the acute phase may implicate hyperfiltration in the residual functioning kidney mass leading to progressive renal disease. ERPF in the 2nd year after D+ HUS may serve as an excellent parameter to detect patients with a high risk of an unfavorable long-term outcome. More... »

PAGES

672-677

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s004670050679

DOI

http://dx.doi.org/10.1007/s004670050679

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1024277339

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/10502125


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