Evidence map›Paper›PMID 41364181›Full record

ArticlePediatric nephrology (Berlin, Germany)2026

Incidence and severity of extrarenal manifestations and outcomes in pediatric hemolytic uremic syndrome: a retrospective cohort study.

Rupesh Raina, Keval Yerigeri, Kush Doshi, Amanda Osagie-Ogbeide, Imad Haq, Sydney Smith, Priyanka Khandelwal, Christoph Licht, Carla Nester, Olivia Boyer

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Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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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

2 citing papers in PubMed.

  1. Constructing unbiased pediatric cohorts in TriNetX.Pediatric nephrology (Berlin, Germany) · 2026
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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Rupesh RainaDepartment of Nephrology, Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, 214 West Bowery Street, Akron, OH, 44308, USA. rraina@akronchildrens.org.
Keval YerigeriCenter for Clinical Informatics Research and Education, The MetroHealth System and the Departments of Internal Medicine, Pediatrics, and Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA.
Kush DoshiDepartment of Nephrology, Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, 214 West Bowery Street, Akron, OH, 44308, USA.
Amanda Osagie-OgbeideCollege of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA.
Imad HaqDepartment of Internal Medicine, Wright State University Boonshoft School of Medicine, Dayton, OH, USA.
Sydney SmithCollege of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA.
Priyanka KhandelwalDivision of Nephrology, Department of Pediatrics, ICMR Center for Advanced Research in Nephrology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Christoph LichtDivision of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Carla NesterDepartment of Pediatrics, The University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA.
Olivia BoyerPediatric Nephrology, Dialysis and Transplantation, MARHEA, Imagine Institute, Necker-Enfants Malades Hospital, Paris Cité University, Paris, France.ORCID http://orcid.org/0000-0002-3957-1359

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPediatric hemolytic uremic syndrome (HUS) is characterized by acute kidney injury (AKI), thrombocytopenia, and microangiopathic hemolytic anemia. While kidney involvement is well recognized, extrarenal manifestations of HUS remain poorly characterized.

methodsWe conducted a retrospective cohort study using TriNetX, a global electronic health record database, to examine the incidence of extrarenal complications and clinical outcomes in children (< 18 years) with HUS. Patients were identified via ICD-10-CM codes from 2000 to 2024. Primary outcomes included the 1-year cumulative incidence of extrarenal manifestations, mortality, and kidney disease progression.

resultsA total of 2362 pediatric patients with HUS were included (mean age 4.04 ± 3.65 years; 47.8% male). At 1 year, hypertensive disease was the most prevalent extrarenal manifestation (24.9%), followed by respiratory, gastrointestinal, neurologic, and cardiovascular complications. Patients with "other" HUS (ICD-10 D59.39) experienced higher rates of extrarenal disease compared to infection-associated or hereditary HUS. Mortality was 2.2% at 1 year, with most deaths occurring within 3 months of diagnosis. AKI occurred in 34.0%, chronic kidney disease (CKD) in 14.6%, and kidney failure in 4.0% of patients. One-year hospitalization, ICU admission, and mechanical ventilation rates were 34.8%, 6.7%, and 5.8%, respectively. After the publication of the 2015 treatment guidelines for HUS, eculizumab use rose significantly; 12.7% of patients received plasmapheresis.

conclusionsIn our cohort, pediatric HUS was associated with significant short- and medium-term extrarenal morbidity. These findings highlight the need for vigilant long-term follow-up and refined treatment strategies targeting extrarenal disease burden in pediatric HUS.

Indexed as

Acute Kidney InjuryHemolytic-Uremic SyndromeAdolescentChildChild, PreschoolDisease ProgressionFemaleGastrointestinal DiseasesHumansHypertensionIncidenceInfantMaleRetrospective StudiesSeverity of Illness IndexAcute kidney injuryChildChronic kidney diseaseComplement systemEculizumabHemolytic uremic syndromeShiga toxins

Identifiers

PMID41364181

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