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Kidney Week

Abstract: SA-PO128

Kinetics of Mature Platelet Fraction as a Tool for Predicting the Time Course of Shiga Toxin-Producing Escherichia coli-Associated Hemolytic Uremic Syndrome (STEC-HUS)

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Ardissino, Gianluigi, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Ria, Thomas, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Mancuso, Maria Cristina, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Capone, Valentina, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Daprai, Laura, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Amico, Valeria, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Spanu, Francesco, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
Background

Shigatoxin-related Hemolytic Uremic Syndrome (STEC-HUS) is a common thrombotic microangiopathy in children characterized by platelet consumption, hemolysis and kidney dysfunction. Being the time course of the disease relatively regular, the description of platelets kinetics, including reticulated platelets, may provide some useful insights for predicting the short-term course of the disease.

Methods

We considered all patients with STEC-HUS referred to our center during the last 5 years. Blood count for both total and reticulated platelets was performed daily with a XN-9000 hematology analyzer since admission until recovery. Results are expressed as absolute number and percentage of total.

Results

Fourty patients with documented STEC-HUS were studied. Results are displayed in the figure showing the time course of total and reticulated platelets in the coohort of patients (time 0 identifies the nadir of total platelets). When immature platelet fraction reaches the threshold of 10% the resolution of thrombocytopenia, thus the beginning of recovery, is approaching and is expected in 24-48 hours.

Conclusion

During the course of STEC-HUS the rise of immature platelet fraction above 10% anticipates (by 24-48 hours) the increase of total platelets count thus predicting the beginning of disease recovery.