Balestracci A, et al. – The clinicians aimed to validate blood urea nitrogen to serum creatinine ratio (BCR) as a prognostic factor in diarrhea–associated hemolytic uremic syndrome (D+HUS). Results revealed that the BCR at admission provided a limited value to predict severe forms of D+HUS.

• This was a retrospective study.
• A complicated course was defined as developing one or more of the following: severe neurological or bowel injury, pancreatitis, cardiac or pulmonary involvement, hemodynamic instability, hemorrhage, and death.
• Data from 161 children were reviewed.
• 50 of them with a complicated disease including five deaths.
• Those with worse evolution presented a lower admission BCR than those with good outcome (22.5 vs. 30.8; p = 0.005).
• BCR at admission displayed a limited ability to identify children at risk of a complicated course, with an AUC of 0.63 (95% CI 0.58–0.71) and an optimal cutoff point of ≤ 26.7, which achieved a sensitivity of 70% (95% CI 55.2–81.7) and a specificity of 56.7% (95% CI 47–66).