Akademik Veri Yönetim Sistemi
57th ESPN Annual Meeting, Athens, Yunanistan, 15 - 18 Ekim 2025, ss.29-30, (Özet Bildiri)
Aims/Purpose: Hemolytic uremic syndrome (HUS) is a common cause of acute kidney injury (AKI) in childhood, frequently associated with Shiga toxin-producing Escherichia coli (STEC). Systemic inflammation plays a crucial role in both the pathogenesis and prognosis of HUS. This study evaluated the utility of the systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) as early biomarkers for renal progression in pediatric patients diagnosed with HUS. Methods: This retrospective study included 46 pediatric patients (11 with atypical HUS) admitted to Ondokuz Mayis University Pediatric Hospital between July 2010 and July 2023. Patients with microangiopathic hemolytic anemia (schistocytes, helmet cells), hemoglobin <9 g/dL, thrombocytopenia (<150,000/mm³), and elevated creatinine for age were included. SII (neutrophil/ lymphocyte × platelets) and SIRI (neutrophil × monocyte/lymphocyte) were calculated along with neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Patients were categorized based on the requirement of dialysis during the acute phase. Statistical analyses were performed using SPSS for Windows, including the Shapiro-Wilk test, ANOVA, Kruskal-Wallis test, Pearson’s, Spearman correlation tests, and regression analysis. Results with p-values <0.05 were considered statistically significant. Results: Higher SII (△ = 0.92, p = 0.013), elevated NLR (△ = 0.51, p = 0.03), increased PLR (p = 0.003) and decreased complement C3 levels (△ = 0.4, p = 0.008) were independently associated with an increased risk of acute dialysis requirement. ROC analysis revealed that SII (AUC = 0.784, p<0.004), SIRI (AUC = 0.775, p = 0.005), and NLR (AUC = 0.797, p = 0.002) effectively distinguished patients who progressed to AKI. The optimal cut-off values identified were 17131 for SII, 207.8 for SIRI, and 0.464 for NLR. Conclusion: SII and SIRI are promising biomarkers for predicting disease severity and renal progression in pediatric HUS patients. Further large-scale studies are required to validate these f indings.