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- Title
Rasburicase improves the outcome of acute kidney injury from typical hemolytic uremic syndrome.
- Authors
Cho, Myung Hyun; Ahn, Yo Han; Lim, Seon hee; Kim, Ji Hyun; Ha, Il-Soo; Cheong, Hae Il; Kang, Hee Gyung
- Abstract
Background: Typical hemolytic uremic syndrome (HUS) causes acute kidney injury (AKI) and serious sequelae of chronic kidney disease (CKD) in some. Hyperuricemia is a common finding in typical HUS that may contribute to kidney damage. We explored whether aggressive management of hyperuricemia with rasburicase could improve outcomes in AKI patients with typical HUS. Methods: We retrospectively analyzed medical records of children with typical HUS admitted to a tertiary center between 2005 and 2017. We compared clinical outcomes of hospitalization and 1-year post-discharge between those with rasburicase treatment (n = 13) and those without (controls, n = 29). Results: With rasburicase treatment, hyperuricemia corrected more rapidly (median 36 vs. 120 h, p < 0.001), and hospital stays were shorter (median 9 vs. 12 days, p = 0.003) than in the controls. There was no difference in dialysis requirement. At 1-year post-discharge, the proportion of patients with impaired kidney function (estimated glomerular filtration rate < 90 mL/min/1.73 m2) was lower in the rasburicase group (7.7% vs. 41.4%, p = 0.036) than in the controls. Hypertension and proteinuria tended to be more common in the controls than in the rasburicase group. Collectively, long-term renal sequelae of impaired kidney function, proteinuria, or hypertension at a 1-year follow-up was less common in the rasburicase group than in the controls (7.7% vs. 62.1%; p = 0.001). Conclusions: Children with typical HUS treated with rasburicase had shorter hospital stays and less long-term sequelae at 1-year post-discharge than those who were not treated with rasburicase. These results support the use of rasburicase to prevent CKD in pediatric patients with typical HUS-associated AKI.
- Subjects
ACUTE kidney failure; CHRONIC kidney failure; GLOMERULAR filtration rate; HEMOLYTIC-uremic syndrome; LENGTH of stay in hospitals; HYPERTENSION; HYPERURICEMIA; OXIDOREDUCTASES; PEDIATRICS; PROTEINURIA; URIC acid; TREATMENT effectiveness; RETROSPECTIVE studies; DISEASE complications
- Publication
Pediatric Nephrology, 2020, Vol 35, Issue 11, p2183
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-020-04644-x