Duration of renal replacement therapy in children with hemolytic uremic syndrome

Abstract

Objective: The hemolytic uremic syndrome (HUS) is one of the major causes of acute kidney injury (AKI) in childhood. Although some authors have described risk factors for severe course or poor prognosis of renal function in HUS, there were no studies investigated prognostic factors associated with duration of renal replacement therapy (RRT). In this study, we investigated characteristics of patients who required long-term RRT comparing patients who did RRT within one week. Methods: We reviewed the medical record of 7 patients admitted to the PICU with HUS and treated with RRT between January 2010 and December 2014. We divided patients into the short-term group, who required RRT within 1 week, and the long-term group, who needed RRT more than 1 week. We compared the two groups characteristics, laboratory data, urine output and fluid balance. Results: Urine output was lower in the long-term group compared to the short-term group on Day 2 to 4 after starting RRT. %fluid overload was not statistically different between two groups in the same period. Conclusion: Pediatric patients with HUS, who continued to have anuria or oliguria for more than four days after initiating RRT, may need long-term RRT.