A multivariate relationship between laboratory data during the evolution of typical hemolytic uremic syndrome children popula- tion

Abstract

Hemolytic uremic syndrome (HUS) is a systemic disease charac- terized by variable degrees of acute nephropathy, thrombocytope- nia and microangiopathic hemolytic anemia. Laboratory and clinical parameters contribute very closely to progression of HUS. To better understand HUS evolution, the association between a set of labo- ratory data and a set of clinical parameters of a HUS population is investigated in this study.We conducted a retrospective study of patients (n = 20) attended with diagnosis of typical HUS in the Pediatric Service of the Hospital Posadas from January 2012 to July 2020. 70% were women, with a mean age of 2.19 year. All laboratory data including those from the emergency department (admission), hospitalization, up to the first post-discharge check-up by external clinics were standardized in innovative report formats.We perform the graphical representation of the evolution over time of several of the important clinical parameters (creatinine, hemato- crit, hemoglobin, among others). We find the creatinine curve rele- vant with well-defined moments in its evolution: rise, plateau and decline. We emphasize that 50% of the patients present a similar descent slope (- 0.353 +/- 0.022 mg/dL/day) regardless of the max- imum value reached by creatinine. Also, analytic platform KNIME was used to evaluate the multivariate relationship between labora- tory data and the evolution plasma creatinine values. We observed a strong correlation between the plasma values of creatinine-urea (positive, r = 0,818), platelets-uric acid (negative, r = 0,610) and di- rect bilirubin-uric acid (positive r = 0,735).The study should be complemented with the comparison of quali- tative variables, as well as with new parameters such as albumin- uria, podocyturia, etc.), in order to generate a model of prediction of patient evolution during the acute period of HUS the disease and after it.