Research Article


DOI :10.26650/jchild.2021.1.860634   IUP :10.26650/jchild.2021.1.860634    Full Text (PDF)

Single Center Experience of Diarrhea Associated Hemolytic Uremic Syndrome in Pediatric Intensive Care Unit

Caner AlparslanMehmet Nur TalayMurat Kanğın

Objective: Hemolytic uremic syndrome (HUS) is characterised by acute kidney injury, hemolytic anemia and thrombocytopenia. In children, it is mostly related with diarrhea (D+). In this paper, we aimed to determine clinical parameters and prognostic factors in D+HUS.

Materials and Methods: This retrospective study was conducted with D+HUS 15 pediatric patients in a pediatric intensive care unit between March 2019 and August 2020. Patients demographics, initial vital signs, laboratory parameters (hemoglobine, hematocrit, white blood cell, platellets, creatinine, urea, uric acid, lactat dehydrogenase, aspartat aminotransferase, alanine aminotransferase, amilase, albumine, C3 and C4), plasma therapy, plasma exchange, RRT type and duration, and the need for blood products were evaluated. Therefore, extra-renal involvement, eculizumab treatment and last follow-up were recorded.

Results: The study group consisted of 9 males (60%) and the median age was calculated as 18 months. In 60% of the patients, RRT was implemented. Peritoneal dialysis (in 5) was the most preferded dialysis method. Five patients (33%) had extra-renal involvement. Nine patients (60%) had completely recovered, therefore proteinuria, chronic kidney disease, end-stage kidney disease and neurologic sequel developed in 3 (20%), 1 (6.6%), 1 (6.6%) and 1 (6.6%), respectively. Hospitalization and oligoanuria duration had a significant impact on sequel development [Hospitalization duration: OR:1.28 (%95 CI:0.77–0.98) (p=0.04), Oligoanuria duration: OR:1.46 (%95 CI:0.94–1) (p=0.04)].

Conclusion: In this study, we showed that hospitalization and oligoanuria duration had a significant impact on sequel development. We believe that there is a need for more clinical studies to delinate more precise mechanisms of the disease and eliminate worse outcomes of D+HUS.

DOI :10.26650/jchild.2021.1.860634   IUP :10.26650/jchild.2021.1.860634    Full Text (PDF)

Çocuk Yoğun Bakımda Diyare İlişkili Hemolitik Üremik Sendrom: Tek Merkez Deneyimi

Caner AlparslanMehmet Nur TalayMurat Kanğın

Amaç: Hemolitik üremik sendrom, akut böbrek hasarı, hemolitik anemi ve trombositopeni ile karakterizedir. Çocuklarda en sık diyare ilişkili HÜS (D+ HÜS) olarak görülmektedir. Bu çalışmada amaç D+HÜS klinik parametrelerinin ve hastalığın sonlanımı açısından öngördürücülerin belirlenmesidir.

Gereç ve Yöntem: Geriye dönük olarak yapılan bu çalışmaya Mart 2019 – Ağustos 2020 tarihleri arasında çocuk yoğun bakımda D+HÜS tanısı alan 15 hasta dahil edildi. Olguların demografik özellikleri, başvuru yaşamsal bulguları, laboratuvar parametreleri (hemoglobin, hemotokrit, beyaz kan hücresi, trombosit, kreatinin, üre, ürik asit, laktat dehidrogenaz, aspartat aminotransferaz, alanin aminotransferaz, amilaz, albümin, C3 ve C4), plazma tedavisi, plazma değişimi, böbrek yerine koyma tedavisi (BYKT) uygulandıysa tipi ve süresi, kan ürünü ihtiyacı olup olmadığı incelendi. Ayrıca olgularda böbrek dışında organ tutulumu varlığı, eculizumab tedavisi kullanımı ve izlemde son durumları kayıt altına alındı.

Bulgular: Çalışma grubunun 9’u (%60) erkek olup, yaş ortalaması ortanca 18 ay olarak hesaplandı. Tüm çalışma grubunun %60’ında BYKT ihtiyacı olup, periton diyalizinin [5 (%33,3)] en sık tercih edilen yöntem olduğu görüldü. Beş olguda (%33,3) böbrek dışı organ tutulumu izlendi. Taburculuk sonrası izlem süresince (ort:9,59±6,03 ay), 9 (%60)’unun normale döndüğü, 3 (%20)’ünün proteinüri, 1 (%6,6)’inde kronik böbrek hastalığı, 1 (%6,6)’inde son dönem böbrek yetmezliği ve 1 (%6,6)’inde de nörolojik sekel kaldığı görüldü. Hastane yatış ve oligoanüri süresinin sekel gelişimi üzerine istatistiksel olarak anlamlı etkisi olduğu görüldü [Hastane yatış süre: OR:1,28 (%95 CI:0,77–0,98) (p=0,04), Oligoanüri süre: OR:1,46 (%95 CI:0,94–1) (p=0,04)].

Sonuç: Bu çalışmada hastane yatış ve oligoanüri süresinin sekel gelişimi üzerine anlamlı etkisi gösterildi. Bu hastalığın daha iyi tanınarak yönetiminin geliştirilmesi ile bu kötü sonuçların azaltılabilmesi için daha çok klinik çalışmaya ihtiyaç olduğunu düşünmekteyiz.


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APA

Alparslan, C., Talay, M., & Kanğın, M. (2021). Single Center Experience of Diarrhea Associated Hemolytic Uremic Syndrome in Pediatric Intensive Care Unit. Journal of Child, 21(1), 13-20. https://doi.org/10.26650/jchild.2021.1.860634


AMA

Alparslan C, Talay M, Kanğın M. Single Center Experience of Diarrhea Associated Hemolytic Uremic Syndrome in Pediatric Intensive Care Unit. Journal of Child. 2021;21(1):13-20. https://doi.org/10.26650/jchild.2021.1.860634


ABNT

Alparslan, C.; Talay, M.; Kanğın, M. Single Center Experience of Diarrhea Associated Hemolytic Uremic Syndrome in Pediatric Intensive Care Unit. Journal of Child, [Publisher Location], v. 21, n. 1, p. 13-20, 2021.


Chicago: Author-Date Style

Alparslan, Caner, and Mehmet Nur Talay and Murat Kanğın. 2021. “Single Center Experience of Diarrhea Associated Hemolytic Uremic Syndrome in Pediatric Intensive Care Unit.” Journal of Child 21, no. 1: 13-20. https://doi.org/10.26650/jchild.2021.1.860634


Chicago: Humanities Style

Alparslan, Caner, and Mehmet Nur Talay and Murat Kanğın. Single Center Experience of Diarrhea Associated Hemolytic Uremic Syndrome in Pediatric Intensive Care Unit.” Journal of Child 21, no. 1 (Jul. 2021): 13-20. https://doi.org/10.26650/jchild.2021.1.860634


Harvard: Australian Style

Alparslan, C & Talay, M & Kanğın, M 2021, 'Single Center Experience of Diarrhea Associated Hemolytic Uremic Syndrome in Pediatric Intensive Care Unit', Journal of Child, vol. 21, no. 1, pp. 13-20, viewed 25 Jul. 2021, https://doi.org/10.26650/jchild.2021.1.860634


Harvard: Author-Date Style

Alparslan, C. and Talay, M. and Kanğın, M. (2021) ‘Single Center Experience of Diarrhea Associated Hemolytic Uremic Syndrome in Pediatric Intensive Care Unit’, Journal of Child, 21(1), pp. 13-20. https://doi.org/10.26650/jchild.2021.1.860634 (25 Jul. 2021).


MLA

Alparslan, Caner, and Mehmet Nur Talay and Murat Kanğın. Single Center Experience of Diarrhea Associated Hemolytic Uremic Syndrome in Pediatric Intensive Care Unit.” Journal of Child, vol. 21, no. 1, 2021, pp. 13-20. [Database Container], https://doi.org/10.26650/jchild.2021.1.860634


Vancouver

Alparslan C, Talay M, Kanğın M. Single Center Experience of Diarrhea Associated Hemolytic Uremic Syndrome in Pediatric Intensive Care Unit. Journal of Child [Internet]. 25 Jul. 2021 [cited 25 Jul. 2021];21(1):13-20. Available from: https://doi.org/10.26650/jchild.2021.1.860634 doi: 10.26650/jchild.2021.1.860634


ISNAD

Alparslan, Caner - Talay, Mehmet Nur - Kanğın, Murat. Single Center Experience of Diarrhea Associated Hemolytic Uremic Syndrome in Pediatric Intensive Care Unit”. Journal of Child 21/1 (Jul. 2021): 13-20. https://doi.org/10.26650/jchild.2021.1.860634



TIMELINE


Submitted08.09.2020
First Revision04.02.2021
Last Revision04.01.2021
Accepted22.02.2021
Published Online17.05.2021

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