{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T05:16:02Z","timestamp":1793164562417,"version":"4.5.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the real-world efficacy and safety of eculizumab in atypical hemolytic uremic syndrome (aHUS) within a Western Chinese cohort, with emphasis on treatment initiation timing and renal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective analysis of 17 aHUS patients treated at Sichuan Provincial People\u2019s Hospital, focusing on the relationship between treatment timing and clinical prognosis. To evaluate timing effects, patients were categorized as Early Initiators (treatment within 7 days of symptom onset, n=9) versus Delayed Initiators (treatment beyond 7 days, n=8) The main outcome measures included hematological parameters, renal function, and adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cohort (n=17, 76.5% female, mean age 43.2 \u00b1 20.0 years) demonstrated significant improvements post-eculizumab: creatinine decreased from 647.0 (439.0, 915.0) to 198.5 (86.5, 749.5) \u03bcmol\/L, eGFR increased from 8.0\u00a0(5.0,\u00a011.0)\u00a0to\u00a022.1\u00a0(6.4,\u00a055.1) mL\/min\/1.73m\u00b2, platelets rose from 75 \u00b1 11 to 143 \u00b1 33\u00d710<jats:sup>9<\/jats:sup>\/L, and LDH declined from 787.5\u00b1908.0\u00a0to\u00a0232.8\u00a0\u00b1\u00a070.0 U\/L (all P&amp;lt;0.001). Early treatment initiation (\u22647 days, n=9) yielded superior outcomes versus delayed (&amp;gt;7 days, n=8): higher renal remission (88.9% vs 12.5%, P=0.003), hematological remission (100% vs 12.5%, P&amp;lt;0.001), and reduced dialysis dependence (0% vs 87.5%, P&amp;lt;0.001), with greater \u0394eGFR (+(19.5 \u00b1 3.1) vs +(2.3 \u00b1 1.7 )mL\/min\/1.73m<jats:sup>2<\/jats:sup>, P=0.016) and \u0394platelets  (+(67.8 \u00b1 9.8) vs +(19.3 \u00b1 7.2)\u00d710<jats:sup>9<\/jats:sup>\/L, P=0.007). Renal survival favored early treatment (log-rank P&amp;lt;0.001), though residual renal impairment persisted. Two non-meningococcal bloodstream infections resolved with antibiotics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings provide the first Chinese evidence supporting early eculizumab initiation (\u22647 days post-symptom onset) significantly improves hematological\/renal outcomes and reduces dialysis dependence in Chinese aHUS patients. Despite residual renal impairment, prompt complement blockade mitigates ESRD risk, supporting time-sensitive intervention in resource-limited settings.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1568082","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T04:10:21Z","timestamp":1750997421000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Real-World effectiveness of eculizumab in atypical hemolytic uremic syndrome: a retrospective study from Western 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