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Most studies of long-term kidney outcomes in STEC-HUS patients focus on CKD progression. Therefore, we aimed to describe the kidney function trajectories and to investigate the association between kidney function at 1, 5 10 years after onset and long-term kidney outcomes
In this retrospective study we included patients with STEC-HUS followed for at least 15 years. Kidney function trajectories were constructed considering kidney function at 1, 5, 10 and ≥ 15 years; 3 patterns were defined: (1) progression, if patients changed from complete recovery (CR) to any CKD stage or if CKD worsened, (2) improvement, if they shifted from any CKD stage to CR or to a milder stage and (3) stable, if remained unchanged.
152 STEC-HUS were analyzed. After one year of follow-up, 47% of them had CR, 22% CKD1 and 32% CKD2-5. At the last medical visit, 46% had CR, 34% CKD1 and 19% CKD2-5 (Figure 1). Despite the percentages seem similar, analysis of kidney trajectories revealed that patients are not the same: 48% were stable, 27% improved and 25% worsened (Figure 2). Notably, 62% of the patients with CKD2-4 in the first year recovered normal kidney function, 70% of them after 5 years of follow-up. The comparison of kidney function trajectory between the first, 5th and 10th year to the last visit, shows that the stability was 48, 59 and 69% respectively.
Kidney function trajectory of patients with STEC-HUS is heterogeneous in which patients change from one group to another and also revealed that 2/3 of CKD2-4 patients could improve and even achieve a CR later during follow-up.