Epidemiology and Clinical of Hemolytic Uremic Syndrome (HUS). Analysis of three observation periods

Abstract

Objectives: A retrospective, longitudinal study of patients with hemolytic uremic syndrome (HUS) in the INSN, conducted in 3 periods in order to get: Obtain information on the epidemiological situation in our country. To analyze if the clinical ,therapeutic, HIT and morbidity aspects, have changed in 412 patients.

Methods: It is reviewed and updated, clinical and epidemiological aspects of 412 patients seen in three periods with HUS, admitted in the Nephrology Service of INSN (1976 - 2009), seen in three periods, as the statistical methods showed: 1976- 1996 (Ref. 20, 22), 1997 - 2001 (Ref. 31), 2002 - 2009 (Ref. 32).

Results: The hospital incidence rate (HIT) has increased significantly during the three periods. There is slight predominance in males (SM) in the last two periods and predominant age was under 24 months. Most came from Lima and Callao, and there was increase of patients who came from place out of Lima in the last period. Spring and summer were the most frecuently seasons in the three periods of the study . Diarrhea prodrome was more 95% as well as dysentery in more than 2/3 cases. Oliguric acute renal failure (ARF), has decreased in the last period and dialysis was performed in 29%, 56% and 46% respectively. The clinical triad of HUS increased from 59% to 79% in the last period. Hypertension (HTN), seizures, and edema were observed in similar proportion in the three periods. Stool cultures were negative in more than 85% and mortality was 2.2% of cases. In the last period there were two cases of familiar HUS autosomic dominant.

Conclusions: HIT has increased substantially during the three study periods of study. The age of presentation is most common in children under two years, with slight predominance in boys in the last two phases. we had patients in every month of the years with a bimodal trend (spring- summer) throughout the observation periods. The predominant clinical form was the epidemic type (except the two familiar cases). In the third phase of the study there was increase of patients who live out of Lima (15%), more non-oliguric form of ARF (39%) two cases of familial HUS autosomic dominant. The mortality was 2.2%.