Hemolytic Uremic Syndrome (cont.)
What is the treatment for hemolytic uremic syndrome?
HUS in children tends to be self-limiting, and supportive care is often all
that is needed. This may include intravenous fluids for rehydration and
rebalancing of electrolytes like sodium and potassium, which can be lost with
the diarrhea.
Blood transfusion are only used for the most severe cases of anemia in which
the hemoglobin falls below 6 or 7 g/dL (depending on age, the normal value is
11-16).
Kidney failure can be managed expectantly (by observation and supportive
care), and dialysis is not often required.
Adults with HUS tend to become more ill and need more aggressive therapy than
children with the condition. In addition to the supportive care discussed above,
plasmapheresis or plasma exchange may be required. Since it is thought there is
an abnormal chemical in the plasma stimulating the abnormal clot formation,
removing the plasma and replacing it with donor plasma is helpful in treating
adult HUS.
Temporary dialysis may be needed while awaiting recovery of the kidneys from
the illness.
What is the outcome of hemolytic uremic syndrome?
HUS in children tends to be self-limiting, and full recovery should be
expected.
Adults do less well. Without aggressive therapy like plasmapheresis and
dialysis, up to 40% of those affected may die, and 80% may have kidney
impairment. With treatment, the death rate falls to 10% or less and kidney
impairment to 25%.
Patients with HUS not related to a diarrheal illness have a worse prognosis
than those whose illness is due to an E. coli infection.
In those patients with genetically caused HUS, relapsing illness is common as
are kidney failure requiring dialysis and death.
How can hemolytic uremic syndrome be prevented?
Most cases of E. coli-related HUS can be prevented by thorough cooking of
hamburger products. The vast majority of cases of HUS are caused by poor food
handling, and proper technique in the kitchen is the key to prevention.
Last Editorial Review: 1/11/2008
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