{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:03:17Z","timestamp":1791378197558,"version":"4.3.2"},"reference-count":45,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T00:00:00Z","timestamp":1730246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Hemolytic uremic syndrome (HUS) is a known cause of acute kidney injury in children, but there are few recent reports on its epidemiology and outcome. We aimed to investigate trends in the incidence and the long-term outcomes of both Shiga toxin-producing Escherichia coli -HUS (STEC-HUS) and atypical HUS (aHUS) in Poland over the last 12 years (2012\u20142023), based on the Polish Pediatric HUS and Pediatric Renal Replacement Therapy (RRT) Registries. Methods: A total of 436 patients (301 with STEC-HUS and 135 with aHUS) were included. Results: The incidence of STEC-HUS increased during the observation period, with a mean of 3.9 cases per million age-related population (marp). The incidence of aHUS was relatively constant with a mean of 1.8\/marp. The majority of patients fully recovered, although kidney sequelae were observed at 5-year follow-ups in 31% of children with STEC-HUS, 57% of aHUS subjects in the pre-eculizumab era, and 37% of aHUS subjects who had received eculizumab. The overall mortality rate was 2% for STEC-HUS and 3.7% for aHUS, with no deaths reported in children on eculizumab and mortality mainly attributed to neurological damage. A decreasing incidence of chronic kidney disease stage 5 (CKD5) due to HUS was observed. Conclusions: Despite an unchanging incidence of aHUS and an increasing incidence of STEC-HUS, the kidney outcomes of both diseases have improved significantly over the last 12 years. Mortality from HUS has dropped due to improved symptomatic treatment and the introduction of anti-C5 therapy. The development of CKD5 in childhood as a consequence of HUS has become exceptional.<\/jats:p>","DOI":"10.3390\/jcm13216499","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T09:10:44Z","timestamp":1730279444000},"page":"6499","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Changing Epidemiology and Outcomes of Hemolytic Uremic Syndrome in Children: A Prospective National Cohort Study from the Polish Pediatric HUS Registry and the Polish Registry of Renal Replacement Therapy in Children"],"prefix":"10.3390","volume":"13","author":[{"given":"Ilona","family":"Zago\u017cd\u017con","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Nephrology and Hypertension, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6772-1983","authenticated-orcid":false,"given":"Maria","family":"Szczepa\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 40-055 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6811-4934","authenticated-orcid":false,"given":"Beata","family":"Leszczy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Nephrology, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wioleta","family":"Jarmu\u017cek","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Kidney Transplantation and Arterial Hypertension, The Children\u2019s Memorial Health Institute, 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0776-4946","authenticated-orcid":false,"given":"Monika","family":"Miklaszewska","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology and Hypertension, Jagiellonian Univeristy Medical College, 31-007 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Tkaczyk","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Immunology and Nephrology, Polish Mother\u2019s Memorial Hospital Research Institute, 93-338 Lodz, Poland"},{"name":"Department of Pediatrics, Nephrology and Immunology, Medical University of Lodz, 93-338 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Medy\u0144ska","sequence":"additional","affiliation":[{"name":"Department and Clinic of Pediatric Nephrology, Medical University of Wroclaw, 02-091 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Wieczorkiewicz-P\u0142aza","sequence":"additional","affiliation":[{"name":"2nd Department of Pediatrics, Department of Pediatric Nephrology, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7365-553X","authenticated-orcid":false,"given":"Jacek","family":"Zachwieja","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology and Hypertension, Pozna\u0144 University of Medical Sciences, 61-701 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Protas","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Nephrology, Medical University of Bialystok, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulina","family":"Rosi\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Specialist Children Hospital, 87-100 Torun, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urszula","family":"Jacher","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nephrology and Dialysis, Pomeranian Medical University, 70-204 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"El\u017cbieta","family":"Trembecka-Dubel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 40-055 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6714-3992","authenticated-orcid":false,"given":"Danuta","family":"Zwoli\u0144ska","sequence":"additional","affiliation":[{"name":"Department and Clinic of Pediatric Nephrology, Medical University of Wroclaw, 02-091 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3354-5344","authenticated-orcid":false,"given":"Aleksandra","family":"\u017burowska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nephrology and Hypertension, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1967","DOI":"10.1007\/s00467-021-05370-8","article-title":"Thrombotic microangiopathy in children","volume":"37","author":"Palma","year":"2022","journal-title":"Pediatr. 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