Schieppati A, Ruggenenti P, Cornejo R P, Ferrario F, Gregorini G, Zucchelli P, Rossi E, Remuzzi G
Division of Nephrology and Dialysis, Ospedali Riuniti, Bergamo, Italy.
J Am Soc Nephrol. 1992 May;2(11):1640-4. doi: 10.1681/ASN.V2111640.
The clinical records of adult patients with a diagnosis of hemolytic uremic syndrome were retrospectively reviewed with the aim of evaluating the long-term outcome of renal function. The setting is the Italian Registry of Haemolytic Uraemic Syndrome, with which 13 Nephrology Centers have participated. Clinical and laboratory data of 43 patients with hemolytic uremic syndrome were evaluated. The mean age at onset was 34.3 +/- 18.3 yr. Men and women were equally affected. No seasonal trend in presentation was observed. In 20 patients, hemolytic uremic syndrome was primitive, whereas in 23, it was associated with another disease (cancer, preeclampsia, malignant hypertension, vasculitides). Gastrointestinal symptoms were the most frequently observed prodromes. Thirty (70%) patients required dialysis during the acute phase of the disease. Six patients died during the acute phase of the disease, and one died later after discharge (overall mortality, 16%). After 1 yr of follow-up, 11 (26%) patients had recovered a normal renal function, 14 (33%) had hypertension and/or renal insufficiency, and 11 (26%) were on regular dialysis. When prognostic factors of survival and recovery of renal function were considered, it was found that older age was associated with higher mortality in the acute phase, whereas severe renal involvement at the onset of the disease (as expressed by elevated serum creatinine) was associated with a long-term unfavorable prognosis.
为评估肾功能的长期转归，我们对诊断为溶血尿毒综合征的成年患者的临床记录进行了回顾性分析。研究背景为意大利溶血尿毒综合征注册研究，有13个肾脏病中心参与其中。我们评估了43例溶血尿毒综合征患者的临床和实验室数据。发病时的平均年龄为34.3±18.3岁。男性和女性受影响的程度相同。未观察到发病的季节性趋势。20例患者的溶血尿毒综合征为原发性，23例与其他疾病（癌症、先兆子痫、恶性高血压、血管炎）相关。胃肠道症状是最常观察到的前驱症状。30例（70%）患者在疾病急性期需要透析。6例患者在疾病急性期死亡，1例在出院后死亡（总死亡率为16%）。随访1年后，11例（26%）患者肾功能恢复正常，14例（33%）有高血压和/或肾功能不全，11例（26%）接受定期透析。在考虑生存和肾功能恢复的预后因素时，发现年龄较大与急性期较高的死亡率相关，而疾病发作时严重的肾脏受累（以血清肌酐升高表示）与长期不良预后相关。
