Fluid restriction versus volume expansion in children with diarrhea-associated HUS: a retrospective observational study.

Pediatric Nephrology : Journal of the International Pediatric Nephrology Association
Pablo BonanyEzequiel Monteverde

Abstract

Fifty percent of patients with typical diarrhea-associated hemolytic uremic syndrome (D+HUS) require kidney replacement therapy (KRT). In these patients, dehydration worsens disease prognosis. We evaluated dialysis requirement, presence of seizures, and mortality rate among patients diagnosed with D+HUS treated with volume expansion (VE) versus fluid restriction (FR). Thirty-five patients with D+HUS were enrolled; 16 received VE and 19 were historical patients who received conventional FR. Upon admission or during treatment, neither group presented evidence of fluid overload. The VE group received higher volumes of saline (VE 27 ml/kg [10-30] over a 3-h period vs. FR 0 ml), had higher urine output after 12 h (VE vs. FR: OR 6.2 [1.2-41.6], P = 0.03), and required less dialysis (VE 2 [12.5%, CI 95% 0-29] vs. FR 9 [47.4%, CI 95% 24-70], P = 0.035). The VE group had an absolute risk reduction of 0.34 (CI 95% 0.07-0.63); hence, three patients treated with VE were required to avoid one KRT. VE also corrected initial hyponatremia and maintained serum sodium within normal ranges. No statistical differences were observed regarding number of patients with seizures (P = 0.08) or mortality (P = 1.0). VE markedly reduces the number of patie...Continue Reading

References

Jun 1, 1968·The Journal of Pediatrics·C A GianantonioG Gallo
Apr 1, 1964·The Journal of Pediatrics·C GIANANTONIOJ MENDILAHARZU
Jan 16, 2009·Pediatrics International : Official Journal of the Japan Pediatric Society·Ichiro KamiokaUNKNOWN Japanese Society for Pediatric Nephrology
Apr 18, 2009·Pediatrics International : Official Journal of the Japan Pediatric Society·Takahide TeramotoNaomi Kondo
May 17, 2011·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·A Bertholet-ThomasP Cochat
Jul 26, 2011·Archives of Pediatrics & Adolescent Medicine·Christina A HickeyPhillip I Tarr
Apr 6, 2012·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Alejandro BalestracciRaquel Eva Wainsztein
Aug 26, 2014·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Gianluigi ArdissinoGiovanna Chidini
Dec 9, 2015·Pediatrics·Gianluigi ArdissinoErminio Torresani
Jul 2, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Laura F AlconcherMiguel Liern
Aug 11, 2018·European Journal of Pediatrics·Gianluigi ArdissinoUNKNOWN ItalKid-HUS Network
Nov 28, 2018·Pediatrics·Leonard G FeldUNKNOWN SUBCOMMITTEE ON FLUID AND ELECTROLYTE THERAPY

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Citations

May 29, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Sebastian LoosRaphael Schild

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