Long term renal outcome of childhood haemolytic uraemic syndrome
OBJECTIVE--To evaluate the long term outcome of renal function in infants and children after diarrhoea associated haemolytic uraemic syndrome. SETTING--The Hospital for Sick Children, Great Ormond Street, and the Royal Free Hospital, London. SUBJECTS--103 children with the syndrome who presented bet...
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| Published in | BMJ Vol. 303; no. 6801; pp. 489 - 492 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
British Medical Journal Publishing Group
31.08.1991
British Medical Association BMJ Publishing Group Ltd BMJ Publishing Group LTD |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0959-8138 0959-8146 1468-5833 1756-1833 |
| DOI | 10.1136/bmj.303.6801.489 |
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| Abstract | OBJECTIVE--To evaluate the long term outcome of renal function in infants and children after diarrhoea associated haemolytic uraemic syndrome. SETTING--The Hospital for Sick Children, Great Ormond Street, and the Royal Free Hospital, London. SUBJECTS--103 children with the syndrome who presented between 1966 and 1985; 88 attended for follow up investigations (40 male, 48 female) with a mean age 11.6 (range 5.2-22.6) years and a mean duration of follow up of 8.5 (range 5.1-21.3) years. MAIN OUTCOME MEASURES--Blood pressure, ratio of early morning urine albumin to creatinine concentration, glomerular filtration rate, and plasma renin activity. RESULTS--The mean (SD) systolic blood pressure standard deviation score was 0.38 (0.67) and diastolic blood pressure SD score was 0.10 (0.76). The geometric mean ratio of overnight urine albumin to creatinine concentration was 1.27 (range 0.03-48.2), significantly higher than the value observed in 77 normal children (0.32 (0.05-1.95), p less than 0.0001). Glomerular filtration rate estimated from the plasma clearance of chromium-51 EDTA was 95.1 (22.7) ml/min/1.73 m2 surface area, and 16 children had a rate of less than or equal to 80 ml/min/1.73 m2. Significant negative correlations were found between glomerular filtration rate and urinary albumin to creatinine ratio (r = -0.41, p less than 0.0001) and glomerular filtration rate and systolic blood pressure SD score (r = -0.48, p less than 0.0001). A significant positive correlation was found between urinary albumin to creatinine ratio and systolic blood pressure SD score (r = 0.25, p = 0.02). CONCLUSIONS--After an acute episode of diarrhoea associated haemolytic uraemic syndrome 31% (27/88) of children had an increased albumin excretion, 18% (16/88) had a reduced glomerular filtration rate and 10% (9/88) had both, in association with a higher systolic blood pressure, indicating considerable residual nephropathy in this group. |
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| AbstractList | OBJECTIVE--To evaluate the long term outcome of renal function in infants and children after diarrhoea associated haemolytic uraemic syndrome. SETTING--The Hospital for Sick Children, Great Ormond Street, and the Royal Free Hospital, London. SUBJECTS--103 children with the syndrome who presented between 1966 and 1985; 88 attended for follow up investigations (40 male, 48 female) with a mean age 11.6 (range 5.2-22.6) years and a mean duration of follow up of 8.5 (range 5.1-21.3) years. MAIN OUTCOME MEASURES--Blood pressure, ratio of early morning urine albumin to creatinine concentration, glomerular filtration rate, and plasma renin activity. RESULTS--The mean (SD) systolic blood pressure standard deviation score was 0.38 (0.67) and diastolic blood pressure SD score was 0.10 (0.76). The geometric mean ratio of overnight urine albumin to creatinine concentration was 1.27 (range 0.03-48.2), significantly higher than the value observed in 77 normal children (0.32 (0.05-1.95), p less than 0.0001). Glomerular filtration rate estimated from the plasma clearance of chromium-51 EDTA was 95.1 (22.7) ml/min/1.73 m2 surface area, and 16 children had a rate of less than or equal to 80 ml/min/1.73 m2. Significant negative correlations were found between glomerular filtration rate and urinary albumin to creatinine ratio (r = -0.41, p less than 0.0001) and glomerular filtration rate and systolic blood pressure SD score (r = -0.48, p less than 0.0001). A significant positive correlation was found between urinary albumin to creatinine ratio and systolic blood pressure SD score (r = 0.25, p = 0.02). CONCLUSIONS--After an acute episode of diarrhoea associated haemolytic uraemic syndrome 31% (27/88) of children had an increased albumin excretion, 18% (16/88) had a reduced glomerular filtration rate and 10% (9/88) had both, in association with a higher systolic blood pressure, indicating considerable residual nephropathy in this group. Objective—To evaluate the long term outcome of renal function in infants and children after diarrhoea associated haemolytic uraemic syndrome. Setting—The Hospital for Sick Children, Great Ormond Street, and the Royal Free Hospital, London. Subjects—103 children with the syndrome who presented between 1966 and 1985; 88 attended for follow up investigations (40 male, 48 female) with a mean age 11.6 (range 5.2-22.6) years and a mean duration of follow up of 8.5 (range 5.1-21.3) years. Main outcome measures—Blood pressure, ratio of early morning urine albumin to creatinine concentration, glomerular filtration rate, and plasma renin activity. Results—The mean (SD) systolic blood pressure standard deviation score was 0.38 (0.67) and diastolic blood pressure SD score was 0.10 (0.76). The geometric mean ratio of overnight urine albumin to creatinine concentration was 1.27 (range 0.03-48.2), significantly higher than the value observed in 77 normal children (0.32 (0.05-1.95), p<0.0001). Glomerular filtration rate estimated from the plasma clearance of chromium-51 EDTA was 95.1 (22.7) ml/min/1.73 m² surface area, and 16 children had a rate of ≤80 ml/min/1.73 m². Significant negative correlations were found between glomerular filtration rate and urinary albumin to creatinine ratio (r=−0.41, p<0.0001) and glomerular filtration rate and systolic blood pressure SD score (r=−0.48, p<0.0001). A significant positive correlation was found between urinary albumin to creatinine ratio and systolic blood pressure SD score (r=0.25, p=0.02). Conclusions—After an acute episode of diarrhoea associated haemolytic uraemic syndrome 31% (27/88) of children had an increased albumin excretion, 18% (16/88) had a reduced glomerular filtration rate and 10% (9/88) had both, in association with a higher systolic blood pressure, indicating considerable residual nephropathy in this group. To evaluate the long term outcome of renal function in infants and children after diarrhoea associated haemolytic uraemic syndrome. The Hospital for Sick Children, Great Ormond Street, and the Royal Free Hospital, London. 103 children with the syndrome who presented between 1966 and 1985; 88 attended for follow up investigations (40 male, 48 female) with a mean age 11.6 (range 5.2-22.6) years and a mean duration of follow up of 8.5 (range 5.1-21.3) years. Blood pressure, ratio of early morning urine albumin to creatinine concentration, glomerular filtration rate, and plasma renin activity. The mean (SD) systolic blood pressure standard deviation score was 0.38 (0.67) and diastolic blood pressure SD score was 0.10 (0.76). The geometric mean ratio of overnight urine albumin to creatinine concentration was 1.27 (range 0.03-48.2), significantly higher than the value observed in 77 normal children (0.32 (0.05-1.95), p less than 0.0001). Glomerular filtration rate estimated from the plasma clearance of chromium-51 EDTA was 95.1 (22.7) ml/min/1.73 m2 surface area, and 16 children had a rate of less than or equal to 80 ml/min/1.73 m2. Significant negative correlations were found between glomerular filtration rate and urinary albumin to creatinine ratio (r = -0.41, p less than 0.0001) and glomerular filtration rate and systolic blood pressure SD score (r = -0.48, p less than 0.0001). A significant positive correlation was found between urinary albumin to creatinine ratio and systolic blood pressure SD score (r = 0.25, p = 0.02). After an acute episode of diarrhoea associated haemolytic uraemic syndrome 31% (27/88) of children had an increased albumin excretion, 18% (16/88) had a reduced glomerular filtration rate and 10% (9/88) had both, in association with a higher systolic blood pressure, indicating considerable residual nephropathy in this group. To evaluate the long term outcome of renal function in infants and children after diarrhoea associated haemolytic uraemic syndrome.OBJECTIVETo evaluate the long term outcome of renal function in infants and children after diarrhoea associated haemolytic uraemic syndrome.The Hospital for Sick Children, Great Ormond Street, and the Royal Free Hospital, London.SETTINGThe Hospital for Sick Children, Great Ormond Street, and the Royal Free Hospital, London.103 children with the syndrome who presented between 1966 and 1985; 88 attended for follow up investigations (40 male, 48 female) with a mean age 11.6 (range 5.2-22.6) years and a mean duration of follow up of 8.5 (range 5.1-21.3) years.SUBJECTS103 children with the syndrome who presented between 1966 and 1985; 88 attended for follow up investigations (40 male, 48 female) with a mean age 11.6 (range 5.2-22.6) years and a mean duration of follow up of 8.5 (range 5.1-21.3) years.Blood pressure, ratio of early morning urine albumin to creatinine concentration, glomerular filtration rate, and plasma renin activity.MAIN OUTCOME MEASURESBlood pressure, ratio of early morning urine albumin to creatinine concentration, glomerular filtration rate, and plasma renin activity.The mean (SD) systolic blood pressure standard deviation score was 0.38 (0.67) and diastolic blood pressure SD score was 0.10 (0.76). The geometric mean ratio of overnight urine albumin to creatinine concentration was 1.27 (range 0.03-48.2), significantly higher than the value observed in 77 normal children (0.32 (0.05-1.95), p less than 0.0001). Glomerular filtration rate estimated from the plasma clearance of chromium-51 EDTA was 95.1 (22.7) ml/min/1.73 m2 surface area, and 16 children had a rate of less than or equal to 80 ml/min/1.73 m2. Significant negative correlations were found between glomerular filtration rate and urinary albumin to creatinine ratio (r = -0.41, p less than 0.0001) and glomerular filtration rate and systolic blood pressure SD score (r = -0.48, p less than 0.0001). A significant positive correlation was found between urinary albumin to creatinine ratio and systolic blood pressure SD score (r = 0.25, p = 0.02).RESULTSThe mean (SD) systolic blood pressure standard deviation score was 0.38 (0.67) and diastolic blood pressure SD score was 0.10 (0.76). The geometric mean ratio of overnight urine albumin to creatinine concentration was 1.27 (range 0.03-48.2), significantly higher than the value observed in 77 normal children (0.32 (0.05-1.95), p less than 0.0001). Glomerular filtration rate estimated from the plasma clearance of chromium-51 EDTA was 95.1 (22.7) ml/min/1.73 m2 surface area, and 16 children had a rate of less than or equal to 80 ml/min/1.73 m2. Significant negative correlations were found between glomerular filtration rate and urinary albumin to creatinine ratio (r = -0.41, p less than 0.0001) and glomerular filtration rate and systolic blood pressure SD score (r = -0.48, p less than 0.0001). A significant positive correlation was found between urinary albumin to creatinine ratio and systolic blood pressure SD score (r = 0.25, p = 0.02).After an acute episode of diarrhoea associated haemolytic uraemic syndrome 31% (27/88) of children had an increased albumin excretion, 18% (16/88) had a reduced glomerular filtration rate and 10% (9/88) had both, in association with a higher systolic blood pressure, indicating considerable residual nephropathy in this group.CONCLUSIONSAfter an acute episode of diarrhoea associated haemolytic uraemic syndrome 31% (27/88) of children had an increased albumin excretion, 18% (16/88) had a reduced glomerular filtration rate and 10% (9/88) had both, in association with a higher systolic blood pressure, indicating considerable residual nephropathy in this group. |
| Audience | Professional |
| Author | Trompeter, R S Shah, V Fitzpatrick, M M Dillon, M J Barratt, T M |
| AuthorAffiliation | Department of Paediatric Nephrology, Institute of Child Health, London |
| AuthorAffiliation_xml | – name: Department of Paediatric Nephrology, Institute of Child Health, London |
| Author_xml | – sequence: 1 givenname: M M surname: Fitzpatrick fullname: Fitzpatrick, M M – sequence: 2 givenname: V surname: Shah fullname: Shah, V – sequence: 3 givenname: R S surname: Trompeter fullname: Trompeter, R S – sequence: 4 givenname: M J surname: Dillon fullname: Dillon, M J – sequence: 5 givenname: T M surname: Barratt fullname: Barratt, T M |
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| Cites_doi | 10.1007/BF00857656 10.1542/peds.76.3.460 10.1136/adc.59.5.397 |
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| References | ki Mluaka P, Iinidi; WV, Proesmans; R, Ecckcls (ref_6) 1981; 136 Habib, R.; Ml, Lesy; MlF, Gagnadoux; Mi, Brover (ref_7) 1982; 14 N1, Sieniawska; J, Korniszewska; C, Gura; J, Wcc-Duobies; Z, Lewicki (ref_10) 1990; 4 Kaplan, B.S. (ref_13) 1977; 8 Ml, Levis; TM, Barratt (ref_1) 1984; 59 Londe, S. (ref_3) 1985; 76 (ref_15) 1990; 65 Heart, National; Ltung; Institute, Blood; Bethesda, Maryland (ref_4) 1987; 79 Karmali, M.I.A.; Stecle, B.T.; Ml, Petric; Lim, C. (ref_2) 1983; i MI)S, Walters; IU, Mlatthei; R, KaN; MIJ, Dillon; TM, Barratt (ref_9) 1989; 3 LesitMM, Walters MlD; TrM, Barratt (ref_12) 1989; 4 Milford, D.V.; White, R.H.R.; Taylor, C.M. (ref_14) 1991; 118 Martin, D.L.; M\lacDonald, K.L.; White, K.E.; Solcr, J.T.; Osterholm, M.I.T. (ref_11); 1990 Ioirat, C.; Sonsino, E.; Varga Moreno, A.; I'illion, G.; Mcercier, J.C.; Beaufils, F. (ref_8) 1984; 73 Kaplats, B.S.; Katz, J.; Krawitz, S.; Lurie, A. (ref_5) 1971; 1 |
| References_xml | – volume: 8 start-page: 495 year: 1977 ident: ref_13 article-title: Hemolytic uremic syndrome with recurrent episodes: an important subset publication-title: Clin Nephrol – volume: 4 start-page: 51 year: 1989 ident: ref_12 article-title: Hemolytic tiremic syndrome publication-title: Adv Pediatr Infect Dis – volume: 73 start-page: 505 year: 1984 ident: ref_8 article-title: Haemol\tic-uremic svndrome: an analysis of the natural history and prognostic features..-cta Pdiaetr Scand – volume: 1990 start-page: 1161 issue: 323 ident: ref_11 article-title: The epidemiology and clinical aspects of the hemolytic uremic syndrome in Minnesota. N' publication-title: Englj.]ed – volume: 4 start-page: 213 year: 1990 ident: ref_10 article-title: Ilrogtsostic significance of certain fcatures in the hemolytic-turemic syndrome publication-title: Pediatr Nephrol doi: 10.1007/BF00857656 – volume: i: start-page: 619 year: 1983 ident: ref_2 article-title: Sporadic cases of haemolytic uracnmic syndrome associated with faecal cytotoxin and cytotoxin-producing Escherichia coli in stools publication-title: Lancet – volume: 3 start-page: 130 year: 1989 ident: ref_9 article-title: 'I'he polymorphonuclear leucocyte count in childhood hemolytic uremic syndrome. Pediatr AVephrol – volume: 65 start-page: 1 issue: 716-2 year: 1990 ident: ref_15 article-title: Haemolytic uraeitic syndromes in the British Isles 1985-8: association with vcrocytotoxin producing Escherichia coli. Part 1: clinical and epidcmiological aspects publication-title: Arch DIis Child – volume: 136 start-page: 237 year: 1981 ident: ref_6 article-title: I'lhc haemutlytic-uracmic svtndrosnc in childhood: a study of the lotlg tcrm prognosis publication-title: Eur] Pedjair – volume: 1 start-page: 420 year: 1971 ident: ref_5 article-title: Aui atialysis of the rcsults of therapy in 67 cascs os the hemolvtic-uremic syndrome publication-title: 7 – volume: 14 start-page: 109 year: 1982 ident: ref_7 article-title: Irrognosis of the hemolytic urcmic sv-tdrome in children publication-title: Adv Nephrol – volume: 76 start-page: 460 year: 1985 ident: ref_3 article-title: Fifth versus fourth Korotkoff phase publication-title: Pediatrics doi: 10.1542/peds.76.3.460 – volume: 118 start-page: 191 year: 1991 ident: ref_14 article-title: Prognostic sigtsificance of proteinuria one year after onset of diarrhea-associated hemoIlytic-uiremic syndrome – volume: 59 start-page: 397 year: 1984 ident: ref_1 article-title: Haemolytic uraemic syndromc publication-title: Arch D)is Child doi: 10.1136/adc.59.5.397 – volume: 79 start-page: "1 year: 1987 ident: ref_4 article-title: Report of the Scconid Task Forcc on Blood Pressurc Control in Children, 1987, Pediatrtcs publication-title: Arch D)is Child; Estimation of glomerular filtration rate from plasma clearance of51 -chromitum edetic acid |
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| Snippet | OBJECTIVE--To evaluate the long term outcome of renal function in infants and children after diarrhoea associated haemolytic uraemic syndrome. SETTING--The... Objective—To evaluate the long term outcome of renal function in infants and children after diarrhoea associated haemolytic uraemic syndrome. Setting—The... To evaluate the long term outcome of renal function in infants and children after diarrhoea associated haemolytic uraemic syndrome. The Hospital for Sick... To evaluate the long term outcome of renal function in infants and children after diarrhoea associated haemolytic uraemic syndrome.OBJECTIVETo evaluate the... |
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| SubjectTerms | Adolescent Adult Albumins Albuminuria - etiology Biological and medical sciences Blood plasma Blood Pressure - physiology Child Child, Preschool Children Complications and side effects Creatinine - urine Dialysis Diarrhea Diarrhea - complications Diarrhea - urine Escherichia coli infections Female Follow-Up Studies Glomerular filtration rate Glomerular Filtration Rate - physiology Hemolytic uremic syndrome Hemolytic-Uremic Syndrome - complications Hemolytic-Uremic Syndrome - physiopathology Hemolytic-Uremic Syndrome - urine Humans Kidney - physiopathology Kidney diseases Male Medical sciences Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure Prognosis Renal failure Renal function Renin - blood Systolic blood pressure Time Factors Urine |
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| Title | Long term renal outcome of childhood haemolytic uraemic syndrome |
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