999 Dialysis in Acute Renal Failure of Hemolytic Uremic Syndrom in Children

Abstract

HUS is known as the most common cause of ARF in previously healthy children. In the absence of a proven specific therapy the treatment is intensive supportive care. Dialysis is the major method of therapy.

The study objectives were to identify the corelations between the type of HUS and short or long term prognosis depending of the method of dialysis, to analyse the risk factors for poor prognosis, the mortality rate and complications.

The clinical retrospective and prospective study is based on 33 cases of HUS admitted in the Department of Dialysis of “Grigore Alexandrescu” Emergency Children Hospital Bucharest from 1997 to 2009.

The lot of study was omogenus, media of age 34 month; almost half of patients(54,5%) were infants. The severity of the disease was 1,96 times higher in infants than other groups of age. 81,8% were D+HUS; 94% had dialysis, peritoneal dialysis(PD) was the prefered modality (60,6%). Mortality rate was 21,2%.

The precocity of dialysis eliminate ARF as cause of death in HUS. Good prognosis factors were: D+HUS, anuria less than 7 days, precocity of dialysis, the absence of complications. Poor prognosis factors were: infant age, MODS, ventilatory support and cerebral hemoragy. The precocity of diagnosis and dialysis in HUS leed to a great survival rate in acute phase of HUS. The key of success therapy in HUS is maintaining the hydroelectrolytic, acidobasic and nutritional balance, precocity of dialysis, aggressive control of hypertension and anemia. The major interest is recently moving to the long term prognosis of HUS.

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