Renal prognosis of shiga-toxin associated hemolytic uremic syndrome according to dialysis therapy

Objective The aim of this study was to investigate the renal prognosis at one year in Shiga toxin–associated hemolytic uremic syndrome (STEC-HUS) based on the type of kidney replacement therapy (KRT): peritoneal dialysis (PD) versus continuous kidney replacement therapy (CKRT). Method We performed a retrospective study, in 4 French PICUs over a 3-year period: 2018 to 2020. Patients aged less than 16 years-old hospitalized for STEC-HUS and requiring KRT. Measurements and Main Results: 45 patients were included, 29 treated with PD and 16 with CKRT. Patients in the PD group were younger (3 vs 5.5 years; p < .05), had a lower HUS severity score (15.1 vs 16.9; p < .05), and a lower hemoglobin level at admission (9.2 vs 10.6g/dL; p < .05) compared to the CKRT group. The parameters that differed between the groups were adjusted for multivariate analysis. We observed a higher GFR at one year in the PD group compared to the CKRT group (127 vs 99.1ml/min/1.73m²; P = .0001). For the secondary outcomes, results have shown a significantly higher number of red blood cells (RBCs) transfusions (p < .05) in the CKRT group, but no difference for the other outcomes. Conclusions These results suggest that PD may be associated with a better renal prognosis at 1 year and less red blood cell transfusions in patients with STEC-HUS.