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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• Hemolytic uremic syndrome (HUS) facts
• What is a "syndrome?"
• What is hemolytic uremic syndrome (HUS)?
• What causes hemolytic uremic syndrome?
• What are the signs and symptoms of hemolytic uremic syndrome?
• How is hemolytic uremic syndrome diagnosed?
• What is the treatment for hemolytic uremic syndrome?
• What is the prognosis of hemolytic uremic syndrome?
• How can hemolytic uremic syndrome be prevented?
• Find a local Nephrologist in your town
• Hemolytic Uremic Syndrome Index

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 transfusions 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 may 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.

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.