Journal Article

Adult haemolytic and uraemic syndrome: causes and prognostic factors in the last decade

Isabelle Tostivint, Béatrice Mougenot, Antoine Flahault, Cécile Vigneau, Marie‐Alyette Costa, Jean‐Philippe Haymann, Jean‐Daniel Sraer and Eric Rondeau

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 17, issue 7, pages 1228-1234
Published in print July 2002 | ISSN: 0931-0509
Published online July 2002 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/17.7.1228
Adult haemolytic and uraemic syndrome: causes and prognostic factors in the last decade

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Background. Haemolytic uraemic syndrome (HUS) is a rare and severe disease of various aetiologies in adults. The effect of fresh frozen plasma (FFP) infusion in adults suffering from HUS is not well defined. The aim of this retrospective study was to analyse the causes of HUS in adults admitted in a single renal intensive care unit (ICU) and to determine the life and renal prognosis factors, while most patients (78%) received FFP infusion.

Methods. We recorded clinical, biological, and histological data of 55 adults admitted in our renal ICU for HUS between 1990 and 1998, 49 of them having had a renal biopsy. By stepwise logistic regression analysis, we examined the parameters that were associated with the in‐hospital mortality and renal function at discharge.

Results. HUS complicated different diseases in 40 patients (HIV infection n=18, nephropathies n=10, allotransplantation n=7, malignant diseases n=5) and appeared as a primary in 15 patients. Factors influencing the in‐hospital mortality were positive HIV serology (odds ratio (OR) >20, P=0.0002) and requirement for haemodialysis (OR >35, P=0.004). A pre‐existing nephropathy was a bad prognosis factor for renal function (OR >99, P=0.02), while fever was associated with better renal prognosis (OR=1/10, P=0.033).

Conclusions. HUS in adults remains a severe disease, with a high mortality rate in HIV patients and in those who required haemodialysis. However, as compared with previous studies, we observed an improvement in renal outcome, particularly in patients with primary HUS, suggesting a beneficial effect of FFP infusion, at least in these forms.

Keywords: adult; fresh frozen plasma infusion; haemolytic uraemic syndrome; plasma exchange; prognosis factors

Journal Article.  4053 words. 

Subjects: Nephrology

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