From January 1968 to December 1984,312 infants and children with hemolytic uremic syndrome were admitted to our unit ; 8 patients died (2.5%) during the acute phase ; 118 children were followed as outpatients at yearly intervals for at least 10 years (mean follow-up 13 years, range 10-19.8 years).
Four evolution patterns at the end of the follow-up were defined :
group 1, complete recovery, 74 (62.7%) ;
group 2, proteinuria with/without hypertension, 21 (17.7%) ;
group 3, reduced creatinine clearance, often in conjunction with proteinuria and hypertension, 19 (16.1%) ;
group 4, end-stage renal failure, 4 (3.4%). We investigated the association between several variables of the acute stage and the long-term evolution.
Most non-anuric patients recovered completely (92.5%), while 38.4% of those with 1-10 days and 69.2% of those with 11 or more days of anuria had chronic renal sequelae.
Similar results were found when analyzing the requirement for peritoneal dialysis.
Of the patients with proteinuria at the 1-year control, 86% had renal abnormalities at the end of the follow-up.
In our experience, although the final outcome was not predictable in every instance, the severity of acute renal failure - as determined by the days of anuria - and the presence of proteinuria 1 year after the acute phase were the most useful prognostic indicators.
Mots-clés Pascal : Hémolyse urémie, Fonction rénale, Etude longitudinale, Pronostic, Exploration, Epidémiologie, Enfant, Homme, Argentine, Amérique du Sud, Amérique, Insuffisance rénale, Appareil urinaire pathologie, Hémopathie, Anémie hémolytique, Rein pathologie
Mots-clés Pascal anglais : Hemolytic uremic syndrome, Renal function, Follow up study, Prognosis, Exploration, Epidemiology, Child, Human, Argentina, South America, America, Renal failure, Urinary system disease, Hemopathy, Hemolytic anemia, Kidney disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0288255
Code Inist : 002B14A05. Création : 15/07/1997.