CONTEXT: The long-term renal prognosis of @entity1 with @entity294 -associated @entity1381 ( @entity1381 ) remains controversial. OBJECTIVES: To quantify the long-term renal prognosis of @entity1 with @entity294 -associated @entity1381 and to identify reasons for different estimates provided in the literature. DATA SOURCES: We searched MEDLINE and Experta Medica (EMBASE) bibliographic databases and conference proceedings, and we contacted experts until February 2003. We also searched the Institute for Scientific Information index and reference lists of all studies that fulfilled our eligibility criteria. The search strategy included the terms @entity1381 , purpura, @entity2106 , @entity526 O157, longitudinal studies, @entity8 , @entity101 , and @entity644 STUDY SELECTION: Any study that followed up 10 or more @entity1 with primary @entity294 -associated @entity1381 for at least 1 year for renal sequelae. DATA EXTRACTION: Two authors independently abstracted data on study and @entity1 characteristics, renal measures, outcomes, and prognostic features. Disagreements were resolved by a third author or by consensus. DATA SYNTHESIS: Forty-nine studies of 3476 @entity1 with a mean follow-up of 4.4 years (range, 1-22 years at last follow-up) from 18 countries, 1950 to 2001, were summarized. At the time of recruitment, @entity1 were aged 1 month to 18 years. In the different studies, @entity204 or permanent @entity454 ( @entity454 ) ranged from 0% to 30%, with a pooled incidence of 12% (95% confidence interval [CI], 10%-15%). A glomerular filtration rate lower than 80 mL/min per 1.73 m2, @entity101 , or @entity644 was extremely variable and ranged from 0% to 64%, with a pooled incidence of 25% (95% CI, 20%-30%). A higher severity of @entity697 was strongly associated with worse long-term prognosis. Studies with a higher proportion of @entity1 with central nervous system symptoms ( @entity772 , @entity410 , or @entity64 ) had a higher proportion of @entity1 who died or developed permanent @entity454 at follow-up (explaining 44% of the between-study variability, P =.01). Studies with a greater proportion of @entity1 lost to follow-up also described a worse prognosis (P =.001) because these @entity1 were typically healthier than those followed up. One or more years after @entity294 -associated @entity1381 , @entity1 with a predicted @entity1011 clearance higher than 80 mL/min per 1.73 m2, no overt @entity644 , and no @entity101 appeared to have an excellent prognosis. CONCLUSIONS: Death or @entity454 occurs in about 12% of @entity1 with @entity294 -associated @entity1381 , and 25% of survivors demonstrate long-term renal sequelae. @entity1 lost to follow-up contribute to worse estimates in some studies. The severity of @entity697 , particularly central nervous system symptoms and the need for initial dialysis, is strongly associated with a worse long-term prognosis.

Long-term renal prognosis of @entity294 -associated XXXX : a systematic review, meta-analysis, and meta-regression.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity644 :: ('MESH:D011507', 'Disease') :: ['proteinuria'] @entity8 :: ('MESH:D007674', 'Disease') :: ['kidney diseases'] @entity697 :: ('MESH:D000208', 'Disease') :: ['acute illness'] @entity410 :: ('MESH:D012640', 'Disease') :: ['seizures'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity294 :: ('MESH:D003967', 'Disease') :: ['diarrhea'] @entity772 :: ('MESH:D003128', 'Disease') :: ['coma'] @entity1381 :: ('MESH:D006463', 'Disease') :: ['hemolytic uremic syndrome', 'hemolytic-uremic syndrome', 'HUS'] @entity1011 :: ('MESH:D003404', 'Chemical') :: ['creatinine'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity2106 :: ('MESH:D011697', 'Disease') :: ['thrombotic thrombocytopenic'] @entity526 :: ('562', 'Species') :: ['Escherichia coli'] @entity454 :: ('MESH:D007676', 'Disease') :: ['end-stage renal disease', 'ESRD']
@entity1381 :: (MESH:D006463,Disease) :: ['hemolytic uremic syndrome']
