Residual kidney function of Shiga toxin-associated hemolytic uremic syndrome according to kidney replacement therapy: An observational analysis
Abstract
BACKGROUND: There is no consensus about choice of kidney replacement therapy (KRT) for acute kidney injury (AKI) in Shiga toxin-associated hemolytic uremic syndrome (STECHUS) in pediatric population. OBJECTIVE: The aim of this study was to analyze residual kidney function (RKF) according to KRT: peritoneal dialysis (PD) versus continuous kidney replacement therapy (CKRT). METHODS AND SETTINGS: We conducted a retrospective study in four French pediatric intensive care units (PICUs) over a three-year period from 2018 to 2020. The patients were under 16 years of age, had been admitted to the hospital with STECHUS and required KRT. RESULTS: Of the 44 patients included, 29 were treated with PD, 15 with CKRT, and none with intermittent hemodialysis (IHD). Patients in the PD group were younger (3.0 vs 5.5 years; p<.05) and tended to have a lower HUS severity score (HSS) (15.1 vs 16.8; p = 0.06) compared to the CKRT group. Endpoints were compared between groups adjusted for center, age, HSS, and KRT duration. We observed a higher glomerular filtration rate (GFR) at one year in the PD group compared to the CKRT group (127.0 vs 99.1ml/min/1.73m²; P<.0001). Considering secondary outcomes, patients in the CKRT group received a higher number of red blood cell (RBC) transfusions (p<.01). CONCLUSION: Our retrospective study showed a higher GFR at one year in children with STEC HUS requiring KRT who underwent PD dialysis compared to CKRT. These results should be considered in light of the study's confounding biases and validated by a prospective randomized study.
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BibTeX
@article{injeyan2026residual,
title = {{Residual kidney function of Shiga toxin-associated hemolytic uremic syndrome according to kidney replacement therapy: An observational analysis}},
author = {Maud Injeyan and Javier Morelos Zaragoza and Chloé Rousseau and Gwenaelle Roussey and Théophile Gaillot and Pauline Berneau and Bruno Ozanne},
journal = {Archives de Pédiatrie},
year = {2026},
month = oct,
doi = {10.1016/j.arcped.2026.105615},
url = {https://hal.science/hal-05789036v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Residual kidney function of Shiga toxin-associated hemolytic uremic syndrome according to kidney replacement therapy: An observational analysis
AU - Maud Injeyan
AU - Javier Morelos Zaragoza
AU - Chloé Rousseau
AU - Gwenaelle Roussey
AU - Théophile Gaillot
AU - Pauline Berneau
AU - Bruno Ozanne
PY - 2026
DA - 2026/10/09
JO - Archives de Pédiatrie
DO - 10.1016/j.arcped.2026.105615
UR - https://hal.science/hal-05789036v1
AB - BACKGROUND: There is no consensus about choice of kidney replacement therapy (KRT) for acute kidney injury (AKI) in Shiga toxin-associated hemolytic uremic syndrome (STECHUS) in pediatric population. OBJECTIVE: The aim of this study was to analyze residual kidney function (RKF) according to KRT: peritoneal dialysis (PD) versus continuous kidney replacement therapy (CKRT). METHODS AND SETTINGS: We conducted a retrospective study in four French pediatric intensive care units (PICUs) over a three-year period from 2018 to 2020. The patients were under 16 years of age, had been admitted to the hospital with STECHUS and required KRT. RESULTS: Of the 44 patients included, 29 were treated with PD, 15 with CKRT, and none with intermittent hemodialysis (IHD). Patients in the PD group were younger (3.0 vs 5.5 years; p<.05) and tended to have a lower HUS severity score (HSS) (15.1 vs 16.8; p = 0.06) compared to the CKRT group. Endpoints were compared between groups adjusted for center, age, HSS, and KRT duration. We observed a higher glomerular filtration rate (GFR) at one year in the PD group compared to the CKRT group (127.0 vs 99.1ml/min/1.73m²; P<.0001). Considering secondary outcomes, patients in the CKRT group received a higher number of red blood cell (RBC) transfusions (p<.01). CONCLUSION: Our retrospective study showed a higher GFR at one year in children with STEC HUS requiring KRT who underwent PD dialysis compared to CKRT. These results should be considered in light of the study's confounding biases and validated by a prospective randomized study.
SN - 0929-693X
SN - 1769-664X
ER -