Evidence map›Paper›PMID 39549043›Full record

ArticlePediatric nephrology (Berlin, Germany)2025

Haemolytic uremic syndrome as a cause of chronic kidney disease stage 5 in children is in retreat: results from the Polish Registry of Kidney Replacement Therapy in children (2000-2023).

Ilona Zagożdżon, Maria Szczepańska, Jacek Rubik, Katarzyna Zachwieja, Anna Musielak, Monika Bratkowska, Irena Makulska, Katarzyna Niwińska, Beata Leszczyńska, Beata Bieniaś and 3 more

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Article in Pediatric nephrology (Berlin, Germany), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Ilona ZagożdżonDepartment of Pediatrics, Nephrology and Hypertension, Medical University of Gdansk, Debinki 7, 80-211, Gdansk, Poland. ilona.zagozdzon@gumed.edu.pl.ORCID http://orcid.org/0000-0002-6435-7776
Maria SzczepańskaDepartment and Clinic of Pediatrics, Nephrology and Endocrinology, Medical University of Silesia, Zabrze, Poland.
Jacek RubikDepartment of Nephrology and Kidney Transplantation, The Childrens Memorial Health Institute, Warsaw, Poland.
Katarzyna ZachwiejaDepartment of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, Krakow, Poland.
Anna MusielakDepartment of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland.
Monika BratkowskaDepartment of Pediatrics, Immunology and Nephrology, Polish Mother's Memorial Hospital - Research Institute in Lodz, Lodz, Poland.
Irena MakulskaDepartment of Pediatric Nephrology, Wroclaw Medical University, Wroclaw, Poland.
Katarzyna NiwińskaDepartment of Pediatrics, Nephrology and Dialysis, Pomeranian Medical University, Szczecin, Poland.
Beata LeszczyńskaDepartment of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland.
Beata BieniaśDepartment of Pediatric Nephrology, Medical University of Lublin, Lublin, Poland.
Katarzyna Taranta-JanuszDepartment of Pediatrics and Nephrology, Medical University of Bialystok, Bialystok, Poland.
Hanna Adamczyk-KipigrochDepartment of Nephrology, Children Hospital, Torun, Poland.
Aleksandra ŻurowskaDepartment of Pediatrics, Nephrology and Hypertension, Medical University of Gdansk, Debinki 7, 80-211, Gdansk, Poland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHaemolytic uremic syndrome (HUS) is a life-threatening disease with a historically poor prognosis in children receiving maintenance kidney replacement therapy (KRT). This study aimed to analyse the incidence and outcome of chronic kidney disease stage 5 (CKD5) due to Escherichia coli-HUS (STEC-HUS) and complement-mediated HUS (CM-HUS) in children, compared with controls with non-HUS CKD5 over the last 24 years.

methodsThe study included 1488 children undergoing KRT in Poland between 2000 and 2023. Thirty-nine patients with CM-HUS and 18 with STEC-HUS were identified and analysed for incidence, KRT modality and survival.

resultsThe incidence rate of CKD5 was 0.09 cases/million age-related population (marp) for STEC-HUS and 0.23/marp for CM-HUS, while no new cases have been observed in recent years. CKD5 due to CM-HUS developed significantly earlier from initial HUS manifestation than in STEC-HUS (median 0.2 vs. 9.8 years). CM-HUS was associated with younger age at initiation of KRT compared to STEC-HUS and non-HUS controls (median 6.0 years vs. 10.9 and 10.9 years), with higher risk of death (Hazard Ratio 1.92, 95% confidence interval 0.9-4.13) and worse 5-year kidney graft survival at 77%, 93% and 90%, respectively (p < 0.001).

conclusionsIn recent years, both CM-HUS and STEC-HUS have become increasingly rare causes of CKD5 in children. CKD5 due to CM-HUS in the eculizumab era and due to STEC-HUS after improving supportive treatment is exceptional. Children on KRT due to STEC-HUS had a significantly better survival, shorter waiting time for kidney transplantation and better kidney graft survival compared to the CM-HUS group.

Indexed as

Escherichia coli InfectionsHemolytic-Uremic SyndromeRenal Replacement TherapyAdolescentChildChild, PreschoolFemaleHumansIncidenceInfantKidney TransplantationMalePolandRegistriesShiga-Toxigenic Escherichia coliChildrenChronic kidney diseaseEpidemiologyHaemolytic uremic syndromeSurvival

Identifiers

PMID39549043
PMCPMC11885394

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.