Síndrome hemolítico urémico en Chile: presentación clínica, evolución y factores pronósticos

• Pedro Zambrano O ^[3] ; Angela Delucchi B ^[4] ; Felipe Cavagnaro S ^[5] ; Pilar Hevia J ^[1] ; María Pía Rosati M ^[1] ; Elizabeth Lagos R ^[1] ; Vilma Nazal Ch ^[6] ; Claudia González C ^[7] ; Patricia Barrera B ^[7] ; Enrique Alvarez L ^[8] ; Viola Pinto S ^[3] ; Paulina Salas del C ^[3] ; Francisco Cano Sen ^[4] ; Angélica Contreras M ^[6] ; Mónica Galanti de la P ^[6] ; Juan Cristóbal Gana A ^[4] ; Julio Zamorano C ^[9] ; Amelia Espinoza B ^[3] ; Patricia Dreves R ^[3] ; Jaime Pereira M ^[3] ; Antonia Bidegain S ^[3] ; Erna Pasten P ^[3] ; Leticia Yáñez P ^[3] ; Verónica Cerda F ^[3] ; Eugenio Rodríguez S ^[4] ; Marlene Aglony I ^[4] ; Elisa Gutiérrez I ^[9] ; Francisca Salas P ^[3] ; Sonia Figueroa Y ^[3] ; Marcela Valenzuela A ^[3] ; Jean Grandy H ^[8] ; Boris Guerra A ^[8] ; Michelangelo Lapadula A ^[3] ; Paula Reutter de la M ^[2] ; Vivian Gallardo T ^[3] ; Douglas Maldonado S ^[3] ; Marta Azocar P ^[4] ; Gabriel Cavada Ch ^[3]
  1. [1] Hospital San Juan de Dios

     Hospital San Juan de Dios

     Santiago, Chile

     
  2. [2] Universidad de Los Andes

     Universidad de Los Andes

     Colombia

     
  3. [3] Hospital de Niños Dr. Exequiel González Cortés Unidad de Nefrología
  4. [4] Hospital Dr. Luis Calvo Mackenna Unidad de Nefrología
  5. [5] Hospital Clínico Pontificia Universidad Católica Unidad de Nefrología Pediátrica
  6. [6] Hospital Roberto del Río Unidad de Nefrología
  7. [7] Hospital Sótero del Río Unidad de Nefrología Infantil
  8. [8] Hospital Clínico San Borja Arriarán Unidad de Nefrología Infantil
  9. [9] Hospital Gustavo Fricke Unidad de Nefrología Infantil

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• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 136, Nº. 10, 2008, págs. 1240-1246
• Idioma: español
• Títulos paralelos:
  • Hemolytic-uremic syndrome in Chile: clinical features, evolution and prognostic factors
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• Resumen

  • Background: Hemolytic-uremic syndrome (HUS) is characterized by acute renal failure, microangiopathic hemolytic anemia and thrombocytopenia. Aim: To describe the characteñstics ofpatients with the diagnosis ofHUS in Chile, and to identify the most reliable early predictors oímorbidity and moñality. Material and methods: The clinical records ofpatients 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. Results: 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 perítoneal dialysis was used in the majoríty of cases (78%). The most frequently isolated etiological agentwas 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. Conclusions: The present study emphasizes important clinical and epidemiological aspeets ofHUSin a Chilean pediatricpopulation.