CONICET | Buscador de Institutos y Recursos Humanos

Approximately 50% of patientswith post diarrhea hemolytic uremic syndrome (D+HUS) evolved to differentstages of chronic kidney disease(CKD). From now on CKD. As it is known, the more days of anuria, thehigher risk of poor long term renal prognosis. Our aim was to look forpredictors of poor long term renal outcome beyond days of anuria. This was anobservational, longitudinal and retrospective study. In our Hospital, all thepatients with HUS are systematically followed at 1,3, 6 and 12 months and thenat least once per year. The collected data are loaded in an access data baseafter each control. The variables analyzed as potential predictors of poorrenal outcome were: gender, age at onset(<1, 1-2 and more than 2 years), severe neurological involvement (seizuresor coma), leucocytes at onset (>or ≤20000/mm3), initial hematocrit (> or ≤ 23 %), red bloodcells transfusion requirement and daysof dialysis (o, 1-9 and 10 o more days). The significant variables in thebivariate analysis (leucocytes, transfusions and days of dialysis) wereincluded in a multivariate test. Weselected transfusions requirement instead of hematocrit because no transfusionrequirement implies that the patients had high hematocrit during all the acutestage. Only transfusions (p=0,0009) and days of dialysis (p<0.0001) weresignificant. Patients with > 10 days of dialysis had a CKD risk increased8.8 times vs. those who did not require it.CI 95 % 4.1- 18.5). There was nostatistical significant difference in patients who did not required dialysisvs. those who required < 10 days. Notransfusion requirement increased CKD risk 3.2 times ( CI 95% 1.6-6.3). Notransfusion requirement due to high hto implies less hemolysis probably relatedto more severe vascular occlusion leading to more ischemia and poor long termrenal outcome.