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Are potassium levels in children with hemolytic uremic syndrome predictive of outcome?

Open Journal of Pediatrics 2012年第4期2卷 264-267页

作者： Miguel M. Glatstein vala snehal Syed Amir Ahmad Dennis Scolnik Division of Clinical Pharmacology and Toxicology Department of Pediatrics The Hospital for Sick Children University of Toronto Canada Division of Neonatal and Pediatric Emergency Medicine Synergy Neonatal and Pediatric Hospital Ahmadabad India Division of Pediatric Emergency Medicine Department of Pediatrics Dana’s Children Hospital University of Tel Aviv Tel Aviv Is-rael Division of Pediatric Emergency Medicine Department of Pediatrics The Hospital for Sick Children University of Toronto Toronto Canada

Objective: To ascertain the role of serum potassium levels in predicting clinical outcomes in diarrhea-associated hemolytic uremic syndrome (HUS D+). Methods: We reviewed clinical and laboratory data from HUS D+ patients at our tertiary care institution from 2001 to 2008. Serum potassium concentration at presentation and during the acute phase of acute renal failure were recorded and related to laboratory parameters and clinical outcomes. Results: 15 HUS D+ cases were identified. E. coli 0157:H7 was found in 9/15 cases (70%). Potassium levels were not predictive of clinical outcomes. Normal serum potassium levels were found in the majority of patients. Potassium levels <3.6 mmol/L were evident at presentation in 3/15 patients (23%), and no patient manifested hyperkalemia even when creatinine levels were concurrently increase. Conclusions: This study suggests the presence of vigorous compensatory mechanisms in the homoestasis of serum potassium levels during HUS D+ disease since neither the increase stool volumes associated with diarrhea nor the presence of renal failure resulted in clinically significant changes in serum potassium levels.

关键词： Diarrhea Hemolytic Uremic Syndrome Hypokalemia Potassium Metabolism Acute Renal Failure

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