Zambrano O Pedro, Delucchi B Angela, Cavagnaro S Felipe, Hevia J Pilar, Rosati M María Pía, Lagos R Elizabeth, Nazal Ch Vilma, González C Claudia, Barrera B Patricia, Alvarez L Enrique, Pinto S Viola, Salas del C Paulina, Cano Sch Francisco, Contreras M Angélica, Galanti de la P Mónica, Gana A Juan Cristóbal, Zamorano C Julio, Espinoza B Amelia, Dreves R Patricia, Pereira M Jaime, Bidegain S Antonia, Pasten P Ema, Yáñez P Leticia, Cerda F Verónica, Rodríguez S Eugenio, Aglony I Marlene, Gutiérrez I Elisa, Salas P Francisca, Figueroa Y Sonia, Valenzuela A Marcela, Grandy H Jean, Guerra A Boris, Lapadula A Michelangelo, Reutter de la M Paula, Gallardo T Vivian, Maldonado S Douglas, Azócar P Marta, Cavada Ch Gabriel
Unidad de Nefrología, Hospital de Niños Dr. Exequiel González Cortés, Santiago, Chile.
Rev Med Chil. 2008 Oct;136(10):1240-6. Epub 2009 Jan 15.
Hemolytic-uremic syndrome (HUS) is characterized by acute renal failure, microangiopathic hemolytic anemia and thrombocytopenia.
To describe the characteristics of patients with the diagnosis of HUS in Chile, and to identify the most reliable early predictors of morbidity and mortality.
The clinical records of patients with HUS aged less than 15 years, attended between January 1990 and December 2003 in 15 hospitals, were reviewed. Demographic, clinical, biochemical, hematological parameters, morbidity and mortality were analyzed.
A cohort of 587 patients aged 2 to 8 years, 48% males, was analyzed. Ninety two percent had diarrhea. At the moment of diagnosis, anuria was observed in 39% of the patients, hypertension in 45% and seizures in 17%. Forty two percent required renal replacement therapy (RRT) and peritoneal dialysis was used in the majority of cases (78%). The most frequently isolated etiological agent was Escherichia coli. Mortality rate was 2.9% in the acute phase of the disease and there was a positive correlation between mortality and anuria, seizures, white blood cell count (WCC)>20.000/mm3 and requirements of renal replacement therapy (p<0.05). Twelve percent of patients evolved to chronic renal failure and the risk factors during the acute phase were the need for renal replacement therapy, anuria, WCC>20.000/mm3, seizures and hypertension.
The present study emphasizes important clinical and epidemiological aspects of HUS in a Chilean pediatric population.
溶血尿毒综合征（HUS）的特征为急性肾衰竭、微血管病性溶血性贫血和血小板减少症。
描述智利确诊为HUS的患者特征，并确定发病率和死亡率最可靠的早期预测指标。
回顾了1990年1月至2003年12月期间在15家医院就诊的15岁以下HUS患者的临床记录。分析了人口统计学、临床、生化、血液学参数、发病率和死亡率。
分析了一组587例年龄在2至8岁之间的患者，其中48%为男性。92%的患者有腹泻症状。诊断时，39%的患者出现无尿，45%的患者出现高血压，17%的患者出现惊厥。42%的患者需要肾脏替代治疗（RRT），大多数病例（78%）采用腹膜透析。最常分离出的病原体是大肠杆菌。疾病急性期的死亡率为2.9%，死亡率与无尿、惊厥、白细胞计数（WCC）>20000/mm3以及肾脏替代治疗需求之间存在正相关（p<0.05）。12%的患者发展为慢性肾衰竭，急性期的危险因素是需要肾脏替代治疗、无尿、WCC>20000/mm3、惊厥和高血压。
本研究强调了智利儿科人群中HUS的重要临床和流行病学方面。
Zotero 插件