Can Mean Lasting Kidney Problems for Kids
By Anthony J. Brown,
Tuesday, September 9, 2003
NEW YORK (Reuters Health) - Children who eat undercooked beef can
become infected with a bug that can cause lasting kidney problems,
new research shows.
Undercooked beef and other food items can
be contaminated with a bacteria called E. coli:O157:H7. Eating tainted
foods causes infection with the microbe, resulting in diarrhea and
other debilitating symptoms such as vomiting, cramps, and fever.
More worrisome, about one in ten children will develop a serious
disease called hemolytic uremic syndrome or HUS.
HUS is known to be the most common cause of
acute kidney failure in children. Although this type of failure
often resolves, findings from the new study indicate many children
who've survived HUS still have long-term kidney problems.
Dr. Amit X. Garg, from the London Health Sciences Centre in Ontario,
Canada, and others reviewed 49 studies that looked at the long-term
kidney outcomes of nearly 3500 children with HUS. The patients ranged
in age from 1 month to 18 years and the average follow-up period
was just over 4 years.
The new findings are reported in this week's Journal of the American
Medical Association (JAMA).
Death or permanent kidney disease occurred in about 12 percent of
patients, the authors note. In addition, 25 percent of HUS survivors
demonstrated long-term kidney problems.
The more severe the initial illness, the greater was the risk of
long-term problems. For example, children whose illness involved
serious conditions like coma or seizures were at increased risk
of dying or having permanent kidney disease. Also, requiring dialysis
for the initial illness was tied to a worse long-term outlook.
So what can be done to help these kids with HUS?
In another study reported in the journal, Dr. Howard Trachtman,
from Schneider Children's Hospital in New Hyde Park, New York, and
colleagues tested a new drug designed to bind to Shiga toxin, the
chemical produced by E. Coli that causes HUS.
SYNSORB Pk, which is produced by Canadian company SYNSORB Biotech,
Inc, is thought to work by blocking the toxin's ability to be absorbed
into the body from the intestines.
The study involved 145 children with HUS who received SYNSORB Pk
or inactive placebo pills for 7 days.
Treatment with SYNSORB did not lessen the severity of HUS. The percentage
of patients who died or had serious non-kidney problems was nearly
the same in both groups -- about 19 percent. Similarly, close to
40 percent of patients in each group required dialysis, an indicator
that their kidneys were not working well.
According to a related editorial, drugs that try to control HUS
once it has occurred may not be the best treatment strategy.
"I think the focus needs to be on preventing HUS," Dr.
Richard L. Siegler, author of the editorial, told Reuters Health.
For example, E. coli-infected patients could be given infusions
of antibodies that neutralize Shiga toxin in the blood and reduce
its ability to cause HUS.