Introduction: Length of the oligoanuric period is the main predictor of renal sequelae in children with postdiarrehal hemolytic uremic syndrome (D+ HUS). We aimed to determine the capacity of the oligoanuric period in the prediction of renal sequelae in children with D+ HUS.
Patients and methods: We reviewed data from all patients with D+ HUS admitted at Hospital Elizalde between 1998-2008, including only those with at least 1 year of follow-up. Renal sequelae were defined by the presence of pathologic albuminuria and/or proteinuria and/or arterial hypertension and/or chronic renal failure; 80 patients were included, belonging to one of two groups (with or without sequelae). Difference in the duration of the oligoanuric period between groups was determined, and the diagnostic capacity of the oligoanuric period to identified renal sequelae was assessed by ROC curve.
Results: 32 patients presented sequelae, representing a prevalence of 40%. Oligoanuric period was significantly longer in patients with sequelae [median 7 days (range 0-14) vs median 0 days (range 0-30); p= 0,0003]. Using ROC curve (aucROC= 0.73) we identified an oligoanuric period ≥ 4 days as the best threshold to predict renal sequelae (sensitivity 68.75%, and specificity 70.83%).
Conclusions: By ROC curve analysis we were unable to identify a cut-off point on the length of the oligoanuric period which predicts renal sequelae with optimum sensitivity and specificity. This observation emphasizes the need of periodic and long-term surveillance of all children who suffered from D+ HUS.