Predictive features of chronic kidney disease in atypical haemolytic uremic syndrome

PLoS One. 2017 May 18;12(5):e0177894. doi: 10.1371/journal.pone.0177894. eCollection 2017.


Chronic kidney disease (CKD) is a frequent and serious complication of atypical haemolytic uremic syndrome (aHUS). We aimed to develop a simple accurate model to predict the risk of renal dysfunction in aHUS based on clinical and biological features available at hospital admission. Renal function at 1-year follow-up, based on an estimated glomerular filtration rate < 60mL/min/1.73m2 as assessed by the Modification of Diet in Renal Disease equation, was used as an indicator of significant CKD. Prospectively collected data from a cohort of 156 aHUS patients who did not receive eculizumab were used to identify predictors of CKD. Covariates associated with renal impairment were identified by multivariate analysis. The model performance was assessed and a scoring system for clinical practice was constructed from the regression coefficient. Multivariate analyses identified three predictors of CKD: a high serum creatinine level, a high mean arterial pressure and a mildly decreased platelet count. The prognostic model had a good discriminative ability (area under the curve = .84). The scoring system ranged from 0 to 5, with corresponding risks of CKD ranging from 18% to 100%. This model accurately predicts development of 1-year CKD in patients with aHUS using clinical and biological features available on admission. After further validation, this model may assist in clinical decision making.

MeSH terms

  • Adult
  • Atypical Hemolytic Uremic Syndrome / complications*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / diagnosis*
  • Risk Factors

Grants and funding

This work was supported by the National Plan for Rare Diseases of the French Ministry of Health (Direction Générale de l’Offre de Soin (DGOS)). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.