The Prevalence and Incidence of Hemolytic Uremic Syndrome in Iran, a Systematic Review and Meta-analysis

Authors

  • Nakysa Hooman Aliasghar Clinical Research Development center, Aliasghar Children Hospital,Iran University of Medical Sciences, Tehran
  • Mahmoud Khodadost Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran
  • Mahnaz Sadeghian Aliasghar Clinical Research Development Unit, Aliasghar Children Hospital, Iran University of Medical Sciences, Tehran
  • Fariba Jahangiri Aliasghar Clinical Research Development Center, Aliasghar Children Hospital,Iran University of Medical Sciences, Tehran,
  • Soudabeh Hosseini Department of Laboratory, Aliasghar Clinical Research Development Center, Aliasghar Children Hospital,Iran University of Medical Sciences, Tehran,
  • Fatemeh Sarvi Department of Biostatistics, School of Public Health, Hamadan University of Medical, Hamadan ,

Abstract

HUS is a leading cause of AKI in infants. Though new classification of HUS is based on underlying disease, it traditionally defines as diarrhea positive (typical) and negative (atypical). We have no figure of the incidence and prevalence of HUS, the underlying disease and the outcome in Iranian patients. This meta-analysis of Iranian studies deals with this matter. We used relevant medical search engines and national databases from 1985 to 2019. We searched manually to detect admissible cross references. All studies assessed for the aspects and the risk of distort by three appraisers. Metaprop package of STAT applied to calculate point prevalence, proportion, and incidence with 95% confidence intervals. A total of 27 articles and one abstract of congress containing 7084 cases met all the inclusion criteria and qualified for the final analysis. Considering 1397 patients with HUS over 33 years of study, the pooled prevalence was 28% (95% CI: 15 to 44) and 18.38 pmp (0.55 pmp/y). In children less than 15 years, the prevalence was 79.82 pmp (2.41 pmp/y). Between 1985 and 2019, atypical HUS was identified in 488 patients with the prevalence of 27.88 pmp (annual prevalence of 0.84 pmp/y of children aged less than 15 years old). The incidence was 9.4 pmp (0.28 pmp/y), contributed to 9.9% (95% CI: 3 to 20) of AKI, and 5.48% (95% CI: 3.5 to 7.9) of CKD and ESRD. The rate of HUS diagnosis was increasing during the previous four decades. HUS consists of a significant number of AKI and ESRD. It needs further prospective longitudinal study.

Author Biographies

  • Nakysa Hooman, Aliasghar Clinical Research Development center, Aliasghar Children Hospital,Iran University of Medical Sciences, Tehran
    Professor, Department of Pediatric Nephrology
  • Mahmoud Khodadost, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran
    Assitant Professor, Department of Epidemiology,
  • Mahnaz Sadeghian, Aliasghar Clinical Research Development Unit, Aliasghar Children Hospital, Iran University of Medical Sciences, Tehran
    Assistant Professor, Department of Pediatric Gastroenterology, 
  • Fariba Jahangiri, Aliasghar Clinical Research Development Center, Aliasghar Children Hospital,Iran University of Medical Sciences, Tehran,
    Assistant Professor, Department of Pediatric Surgery,
  • Fatemeh Sarvi, Department of Biostatistics, School of Public Health, Hamadan University of Medical, Hamadan ,

    Department of Biostatistics, 

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Published

2020-05-02

Issue

Section

REVIEW | Kidney Diseases