Dopplersonographische Untersuchungen im Langzeitverlauf von Kindern mit hämolytisch-urämischem Syndrom

AIM: In the present study, we compared the diagnostic value of Doppler sonography with "B-Imaging" in the acute and chronical period of the HUS in children. METHOD: For this, we analysed the Doppler sonographic measurement (Acuson-128) from 3 patients in the acute stage of the disease and 14 patients after approximately 5 years. All patients examined in the chronic stage of the disease had been treated by peritoneal dialysis in the acute stage. As a control, the Doppler sonographic analysis of the A. renalis was performed in 25 healthy children. RESULTS: During the acute phase of the HUS, we found a significant increase in both the resistive index (RI) and the pulsatility index (PI). In addition, the diastolic current in the A. renalis was decreased or the blood flow was reversed. The kidney volume as well as the echo was increased in all cases. A recovery of the kidney observed as beginning diuresis coincided with a return to normal parameters in the Doppler sonographic measurement. In patients examined after 5 years, both the RI and the PI value was significantly (p < 0.01) different from the control group. These parameters correlate with the effective renal plasma flow, but not with the glomerular filtration rate. CONCLUSION: We conclude that in the acute stage of the HUS either "B-Imaging" or duplex sonography yield pathological parameter values. For the observation of the renal symptoms during the chronic phase of the disease, duplex sonography is clearly superior.