References

nid

Нефрология и диализ

Nephrology and Dialysis

1680-44222618-9801

Российское диализное общество

nid-441

Research Article

ОРИГИНАЛЬНЫЕ СТАТЬИ

ORIGINAL ARTICLES

Гемолитико-уремический синдром у детей: эпидемиология, особенности клинико-лабораторного течения, лечение и исходы (Одноцентровое исследование)

Hemolytic uremic syndrome in children: epidemiology, clinical and laboratory findings, treatment and outcomes (Single center study)

Байко

С. В.

Baiko

S. V.

baiko@yandex.ru

Сукало

А. В.

Sukalo

A. V.

noemail@neicon.ru

Судновская

К. А.

Sudnovskaya

K. A.

noemail@neicon.ru

Белорусский государственный медицинский университетРоссияBelarusian State Medical UniversityRussian Federation

Белорусский государственный медицинский университет; Национальная академия наук БеларусиРоссияBelarusian State Medical University; Belarusian National Academy of SciencesRussian Federation

УЗ «Минская областная детская клиническая больница»РоссияMinsk Regional Children’s HospitalRussian Federation

2016

19082024

183282299

2024

Байко С.В., Сукало А.В., Судновская К.А.

Baiko S.V., Sukalo A.V., Sudnovskaya K.A.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://journal.nephro.ru/jour/article/view/441

Гемолитико-уремический синдром (ГУС) является наиболее частой причиной острой почечной недостаточности у детей раннего возраста. Цель исследования: оценить заболеваемость ГУС у детей в республике Беларусь, изучить возрастные и половые различия, сезонные колебания, распространенность различных вариантов ГУС, а также гематологические и биохимические изменения крови и их динамику в процессе восстановления функции почек, степень диагностической значимости маркеров острого повреждения почек, активации комплемента, тромбоза и воспаления. Материалы и методы: в проспективное, продольное, непрерывное исследование включено 218 детей, перенесших ГУС за период 2005-2014 г. в Беларуси. Результаты: ГУС наиболее часто развивается у детей в возрасте до 5 лет (89,9%), встречается с одинаковой частотой среди представителей обоих полов, чаще среди городского населения. Заболеваемость составила 3,9 случая на 100 000 детского населения в возрасте <5 лет и 1,5 в возрасте <15 лет. Наиболее частый вариант ГУС - диарея-ассоциированный (96,3%), связь с шига-токсином которого подтверждена в 49,5% случаев. Описаны особенности клинико-лабораторного течения заболевания и лечения у детей, получавших заместительную почечную терапию и без нее. Перитонеальный диализ был методом выбора у 77,9% пациентов, нуждавшихся в диализной терапии. Выводы: применение ряда организационных мероприятий, диагностических и лечебных рекомендаций позволило снизить летальность у детей с ГУС до 2,3%. Результаты лечения детей с атипичным ГУС остаются неудовлетворительными.

Hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure in children under 5. Aim: to assess the incidence of HUS in children in Belarus, to study its age and sex differences, seasonal variations, incidence of different variants of HUS, as well as hematological and biochemical blood changes and their dynamics in the process of recovery of renal function, the diagnostic significance of markers of acute kidney injury, complement activation, thrombosis and inflammation. Materials and methods: 218 children with HUS were included to a prospective, long-term, uninterrupted study for the 10 year period 2005-2014 in Belarus. Results: HUS more often develops in children under the age of 5 years (89.9%), occurs with equal frequency among both sexes, more often in the urban population. The incidence was 3.9 cases per 100 000 children population of age <5 years and 1.5 at the age of <15 years. The most common type of HUS is diarrhea-associated (96.3%), a link with Shiga-toxin was confirmed in 49.5% of cases. The clinical and laboratory changes of the disease and treatment in those who received renal replacement therapy and without it were described. Peritoneal dialysis has been the method of choice in 77.9% of patients requiring dialysis therapy. Conclusions: the use of a number of organizational, diagnostic and treatment recommendations allowed reducing mortality in children with HUS to 2.3%. The results of treatment of children with atypical HUS remain unsatisfactory.

гемолитико-уремический синдромэпидемиологиязаболеваемостьлетальностьдетиклинические изменениялабораторные показателиNGALвитамин ДС3 фракция комплементаhemolytic uremic syndromeepidemiologyincidencemortalitychildrenclinical changeslaboratory findingsNGALvitamin DC3 complement

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The authors declare that there are no conflicts of interest present.