Abstract：
BACKGROUND: Most studies regarding kidney outcomes in patients with Shiga toxin-producing Escherichia coli-hemolytic uremic syndrome (STEC-HUS) focus on kidney status at last assessment. We aimed to describe patterns of changes in kidney function during follow-up and investigate associations between kidney function at 1st, 5th, and 10th year after onset and long-term kidney outcomes.
METHODS: Data of patients with STEC-HUS followed for at least 15 years were analyzed. Kidney function patterns were constructed considering kidney status at 1st, 5th, 10th, and ≥ 15 years and defined as (1) progressive, if patients changed from complete recovery to any chronic kidney disease (CKD) stage or if CKD worsened; (2) improvement, if they shifted from any CKD stage to complete recovery or to a milder stage; and (3) stable, if remained unchanged.
RESULTS: Of 152 patients included, after 1 year of follow-up, 47% had complete recovery, 22% CKD1, and 32% CKD2-5. At last assessment, 46% had complete recovery, 34% CKD1, and 19% CKD2-5. Despite percentages seeming similar, patients differed: 48% were stable, 27% improved, and 25% worsened. Further, 62% of patients with CKD2-4 in the 1st year normalized their glomerular filtration rate (GFR) thereafter. Comparison of kidney function between 1st, 5th, and 10th year to last assessment shows a stable pattern in 48, 59, and 69% respectively.
CONCLUSIONS: Changes in kidney function showed a dynamic and complex behavior, with patients moving from one group to another. Consistently, kidney function neither at the 1st, 5th, or 10th year was representative of final outcome. Unexpectedly, two-thirds of patients with CKD2-4 after 1 year achieved normal eGFR later during follow-up.
METHODS: Data of patients with STEC-HUS followed for at least 15 years were analyzed. Kidney function patterns were constructed considering kidney status at 1st, 5th, 10th, and ≥ 15 years and defined as (1) progressive, if patients changed from complete recovery to any chronic kidney disease (CKD) stage or if CKD worsened; (2) improvement, if they shifted from any CKD stage to complete recovery or to a milder stage; and (3) stable, if remained unchanged.
RESULTS: Of 152 patients included, after 1 year of follow-up, 47% had complete recovery, 22% CKD1, and 32% CKD2-5. At last assessment, 46% had complete recovery, 34% CKD1, and 19% CKD2-5. Despite percentages seeming similar, patients differed: 48% were stable, 27% improved, and 25% worsened. Further, 62% of patients with CKD2-4 in the 1st year normalized their glomerular filtration rate (GFR) thereafter. Comparison of kidney function between 1st, 5th, and 10th year to last assessment shows a stable pattern in 48, 59, and 69% respectively.
CONCLUSIONS: Changes in kidney function showed a dynamic and complex behavior, with patients moving from one group to another. Consistently, kidney function neither at the 1st, 5th, or 10th year was representative of final outcome. Unexpectedly, two-thirds of patients with CKD2-4 after 1 year achieved normal eGFR later during follow-up.
摘要：
背景：大多数关于产志贺毒素的大肠杆菌-溶血性尿毒综合征(STEC-HUS)患者肾脏结局的研究最终关注肾脏状态。我们旨在描述随访期间肾功能的变化模式，并调查1岁时肾功能之间的关联。5th,发病后第10年和长期肾脏结局。
方法：对随访至少15年的STEC-HUS患者的数据进行分析。肾功能模式的构建考虑肾脏状态在1,5th,第十,≥15年，定义为(1)渐进的，如果患者从完全恢复到任何慢性肾脏疾病（CKD）阶段或CKD恶化;（2）改善，如果他们从任何CKD阶段转移到完全恢复或更温和的阶段；和（3）稳定，如果保持不变。
结果：纳入152例患者，经过1年的随访，47%已完全康复,22%的CKD1和32%的CKD2-5。在最后的评估中，46%已完全康复，34%的CKD1和19%的CKD2-5。尽管百分比看起来相似，患者不同：48%是稳定的，提高了27%,25%恶化。Further,在第1年，有62％的CKD2-4患者的肾小球滤过率（GFR）恢复正常。1、之间的肾功能比较5th,截至去年的第10年评估分别显示了48％，59％和69％的稳定模式。
结论：肾功能的变化表现出动态和复杂的行为，患者从一个群体转移到另一个群体。始终如一，肾脏功能在1号都没有，5th,或第10年代表最终结果。出乎意料的是,2/3的CKD2-4患者1年后在随访期间达到正常eGFR.
方法：对随访至少15年的STEC-HUS患者的数据进行分析。肾功能模式的构建考虑肾脏状态在1,5th,第十,≥15年，定义为(1)渐进的，如果患者从完全恢复到任何慢性肾脏疾病（CKD）阶段或CKD恶化;（2）改善，如果他们从任何CKD阶段转移到完全恢复或更温和的阶段；和（3）稳定，如果保持不变。
结果：纳入152例患者，经过1年的随访，47%已完全康复,22%的CKD1和32%的CKD2-5。在最后的评估中，46%已完全康复，34%的CKD1和19%的CKD2-5。尽管百分比看起来相似，患者不同：48%是稳定的，提高了27%,25%恶化。Further,在第1年，有62％的CKD2-4患者的肾小球滤过率（GFR）恢复正常。1、之间的肾功能比较5th,截至去年的第10年评估分别显示了48％，59％和69％的稳定模式。
结论：肾功能的变化表现出动态和复杂的行为，患者从一个群体转移到另一个群体。始终如一，肾脏功能在1号都没有，5th,或第10年代表最终结果。出乎意料的是,2/3的CKD2-4患者1年后在随访期间达到正常eGFR.
