Incidence and index of severity of hemolytic uremic syndrome in a 26 year period in F ukushima Prefecture, J apan

Background There have been a number of reports on large outbreaks of hemolytic uremic syndrome ( HUS ), but there have been no long‐term studies of sporadic HUS in J apan. This study therefore investigated the epidemiology and prognosis of HUS in F ukushima Prefecture over a 26 year period. Methods The medical records of 26 patients with HUS between 1987 and 2012 were collected. These children were divided into two groups: those with HUS following an episode of gastroenteritis, often with bloody diarrhea ( D + HUS ; n  = 24) and those with HUS not associated with prodromal diarrhea ( D–HUS ; n  = 2). The D + HUS group was further subdivided into group A (11 patients requiring dialysis) and group B (13 patients not requiring dialysis). The epidemiological and clinical data, as well as prognosis, were retrospectively investigated for each group. Results Approximately 90% of HUS patients belonged to the D + HUS group. In this group, the mean number of patients per year from 1987 to 1999, and from 2000 to 2012 was 0.92 ± 0.95, and 1.08 ± 0.86, respectively. On admission, lactate dehydrogenase ( LDH ), alanine aminotransferase ( ALT ), blood urea nitrogen ( BUN ), serum creatinine and serum fibrinogen degradation product ( FDP ) levels in group A were all higher than in group B . Serum albumin level and estimated glomerular filtration rate (e GFR ) in group A were lower than in group B . At 6 months after the onset of HUS in the D + HUS group, renal function was normal. Conclusions The frequency of HUS was constant from 1987 to 2012 in Fukushima. and serum LDH , ALT , BUN , creatinine, and FDP levels as well as e GFR might be risk factors for dialysis in D + HUS children.