Long-term follow-up of Czech children with D+ hemolytic-uremic syndrome

• Published in: Pediatric nephrology (Berlin, West) Vol. 17; no. 6; pp. 400 - 403
• Main Authors: BLAHOVA, Kveta, JANDA, Jan, KREISINGER, Jiri, MATEJKOVA, Eva, SEDIVA, Anna
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01-06-2002; Springer Nature B.V
• Subjects: Adolescent; Adult; Age of Onset; Antigens; Biological and medical sciences; Blood & organ donations; Blood pressure; Chi-square test; Child; Child, Preschool; Czech Republic; Diarrhea; Diarrhea - etiology; E coli; Female; Follow-Up Studies; Hematuria; Hemodialysis; Hemolytic-Uremic Syndrome - complications; Hemolytic-Uremic Syndrome - epidemiology; HLA-DQ Antigens - analysis; HLA-DR Antigens - analysis; HLA-DR Serological Subtypes; Humans; Hypertension; Kidney Diseases - epidemiology; Kidney Diseases - etiology; Kidney Failure, Chronic - epidemiology; Kidney Failure, Chronic - etiology; Kidneys; Male; Medical schools; Medical sciences; Nephrology. Urinary tract diseases; Pediatrics; Peritoneal dialysis; Prevalence; Prognosis; Reference Values; Serology; Urinary system involvement in other diseases. Miscellaneous; Urine; Czech Republic; Kidney disease; Human; HLA-System; Urinary system disease; Prognosis; Prevalence; Hemolytic uremic syndrome; Survivor; HLA-DR-System; Diarrhea; Hemopathy; Long term; Result; Symptomatology; Chronic; Hemolytic anemia; Renal failure; Digestive diseases; Intestinal disease; Comparative study
• ISSN: 0931-041X; 1432-198X
• DOI: 10.1007/s00467-002-0836-z

Fifty-seven children (f/m=31/26) who survived diarrhea (D) + hemolytic uremic syndrome (HUS) were evaluated. The examinations were performed 1-27 years (median 7 years) from the onset of the acute disease. Patients aged 2.3-27 years (median 10 years) were allocated to three groups: Recovery (R, complete recovery), Residual renal symptoms (RRS, hematuria and/or proteinuria and/or hypertension with glomerular filtration rate (GFR) >80 ml/min/1.73 m(2), or moderate renal insufficiency with slightly decreased GFR to 60-80 ml/min/1.73 m(2) with or without residual renal symptoms), and Chronic renal insufficiency/failure (CRI/F, dialysis, transplantation - GFR <60 ml/min/ 1.73 m(2)). Results from 18 patients who survived more than 10 years after HUS demonstrated a high prevalence of renal damage. Only 6/18 patients were in group R, 7/18 patients were in group RRS and 5/18 patients were in group CRI/F. An early onset of HUS (36 patients between 0 and 2 years) was associated with a better prognosis when compared with late onset (21 patients aged more than 2 years), P=0.009. Serology typing of Human leukocyte antigens (HLA) classes I and II in 64 patients revealed a significantly higher frequency of DR9 antigen ( P=0.0037) and a lower frequency of DQ1 antigen ( P=0.009) in D+HUS patients compared with healthy Czech blood donors.
Our study demonstrates a high prevalence of late renal damage in Czech patients surviving after D+HUS. The HLA typing in our group revealed a significantly higher rate of HLA DR9 haplotypes in D+HUS patients.