Recovery of renal function after long-term dialysis in hemolytic uremic syndrome

Brunner, K.; Bianchetti, Mario G.; Neuhaus, Thomas J.

doi:10.1007/s00467-003-1337-4

Cited by 11 publications

(12 citation statements)

References 8 publications

(17 reference statements)

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“…However, ESRD had been reported to develop 4-17 years after acute episodes of HUS [20]. On the other hand, recovery of renal function after long-term dialysis in HUS has been reported by Brunner et al [3]. Therefore, renal sequelae after pneumococcus-associated HUS might be controversial.…”

Section: Discussionmentioning

confidence: 95%

Hemolytic uremic syndrome associated with pneumococcal pneumonia in Taiwan

et al. 2006

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Streptococcus pneumoniae ( S. pneumoniae ) has been associated with hemolytic uremic syndrome (HUS), which is an unusual but serious disease in childhood. We conducted a retrospective review of children aged less than 18 years with S. pneumoniae -associated HUS in northern Taiwan from January 2000 to June 2005. The demographic characters, clinical courses, and outcomes were analyzed. Seven children (three girls, four boys) with S. pneumoniae -associated HUS were studied. The median age at onset of HUS was 40 months (range: 25-60 months). The median duration of hospital stay was 36 days (range: 15-50 days). The interval between the onset of illness attributable to S. pneumoniae and the development of HUS was around 1-2 weeks. The onset of oliguria developed within 2 weeks after illness. Six patients required dialysis with median duration of 16 days. Three patients had leukopenia as the initial presentation. All seven patients had pneumococcal pneumonia complicating with empyema, and two of them received decortication via video-assisted thoracoscopic surgery. Between patients who needed dialysis or not, there was no significant difference in age, sex, duration of thrombocytopenia, incidence of extra-renal complications, such as hepatitis, pancreatitis, and hypertension, and length of hospital stay. The seven patients survived with normal renal function. HUS is a potentially fatal complication of S. pneumoniae infection. Clinicians managing patients with pneumococcal pneumonia with empyema accompanied by leukopenia should beware of the development of HUS. The long-term prognosis for recovery of renal function appears to be good in these patients in northern Taiwan.

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Section: Discussionmentioning

confidence: 95%

Hemolytic uremic syndrome associated with pneumococcal pneumonia in Taiwan

et al. 2006

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“…Amazingly, recovery has been reported in two children following anuria and dialysis that persisted for 8 and 16 months, respectively [45].…”

Section: Prevention and Treatmentmentioning

confidence: 97%

Hemolytic uremic syndrome; pathogenesis, treatment, and outcome

Siegler

Oakes

2005

Current Opinion in Pediatrics

137

102

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“…Dialysis needs to be continued until recovery. Considerable renal function recovery following up to 16 months of dialysis has been reported 40 …”

Section: Typical Haemolytic Uraemic Syndromementioning

confidence: 99%

Haemolytic uraemic syndrome: An overview (Review Article)

Amirlak

2006

Nephrology

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SUMMARY:Haemolytic uraemic syndrome (HUS) is the most common cause of acute renal failure in children. The syndrome is defined by triad of microangiopathic haemolytic anaemia, thrombocytopenia and acute renal failure (ARF). Incomplete HUS is ARF with either haemolytic anaemia or thrombocytopenia. HUS is classified into two subgroups. Typical HUS usually occurs after a prodrome of diarrhoea (D+HUS), and atypical (sporadic) HUS (aHUS), which is not associated with diarrhoea (D-HUS). The majority of D+HUS worldwide is caused by Shiga toxin-producing Esherichia coli (STEC), type O157:H7, transmitted to humans via different vehicles. Currently there are no specific therapies preventing or ameliorating the disease course. Although there are new therapeutic modalities in the horizon for D+HUS, present recommended therapy is merely symptomatic. Parenteral volume expansion may counteract the effect of thrombotic process before development of HUS and attenuate renal injury. Use of antibiotics, antimotility agents, narcotics and non-steroidal anti-inflammatory drugs should be avoided during the acute phase. Prevention is best done by preventing primary STEC infection. Underlying aetiology in many cases of aHUS is unknown. A significant number may result from underlying infectious diseases, namely Streptococcus pneumoniae and human immunedeficiency virus. Variety of genetic forms include HUS due to deficiencies of factor H, membrane cofactor protein, Von Willebrand factor-cleaving protease (ADAMTS 13) and intracellular defect in vitamin B12 metabolism. There are cases of aHUS with autosomal recessive and dominant modes of inheritance. Drug-induced aHUS in post-transplantation is due to calcineurin-inhibitors. Systemic lupus erythematosus and catastrophic antiphospholipid syndrome may also present with aHUS. Therapy is directed mainly towards underlying cause.

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Recovery of renal function after long-term dialysis in hemolytic uremic syndrome

Cited by 11 publications

References 8 publications

Hemolytic uremic syndrome associated with pneumococcal pneumonia in Taiwan

Hemolytic uremic syndrome associated with pneumococcal pneumonia in Taiwan

Hemolytic uremic syndrome; pathogenesis, treatment, and outcome

Haemolytic uraemic syndrome: An overview (Review Article)

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