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2017 ; 17
(2
): 42-48
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Characteristics and outcome of hemolytic uremic syndrome in Sudanese children in
a single Centre in Khartoum State
#MMPMID29545664
Ahmed Ali EM
; Abbakar NM
; Abdel Raheem MB
; Ellidir RA
Sudan J Paediatr
2017[]; 17
(2
): 42-48
PMID29545664
show ga
Hemolytic uremic syndrome (HUS) is one of the important causes of acute kidney
injury (AKI) and chronic kidney disease (CKD) in children. Proposed prognostic
features are controversial. We reviewed, retrospectively, the records of children
with HUS seen at Soba hospital, Khartoum (2004-2012). We aimed to study
demographics, clinical/ laboratory features, outcome and prognostic risk factors.
Thirty-nine children with HUS were recorded; 59% had diarrhoea positive (D+) and
41% diarrhoea negative (D-) HUS. The mean age was 65.4 months and males were
61.5%. At the acute phase seizures, coma, anuria/oliguria and hypertension were
present in 25%, 17.9%, 51.3% and 53.8% respectively. Severe anaemia,
thrombocytopenia, and leukocytosis were present in 71.8%, 97.4%, and 28.2%
respectively. On discharge, hypertension was detected in 23.1%. Clinical and
laboratory features were not significantly different in D+ and D- cases (P > 0.05
for all parameters). Dialysis was undertaken in 84.6% and acute mortality was
12.8% being significantly higher in D+ (P = 0.002). Demographic, clinical and
laboratory features, late referral or need for dialysis were not significantly
associated with higher risk of acute mortality (p > 0.05 for all). At short-term
follow up (mean period ± SD of 18.54 ± 13.21 months), 51.3% had complete renal
recovery, 15.4% CKD 3-4, 12.8% CKD 5 requiring renal replacement therapy (RRT),
and 20.5% died. Higher mean serum creatinine and hypertension on discharge were
risk factors for adverse outcome (CKD5 requiring RRT or death), P = 0.011 and
0.00 respectively. In spite of institution of RRT and supportive therapy, our
data showed less favourable outcome of HUS.
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