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Pediatric Nephrology
Published in: Pediatric Nephrology 10/2008

Open Access 01-10-2008 | Educational Review

Treatment and outcome of Shiga-toxin-associated hemolytic uremic syndrome (HUS)

Authors: Johanna Scheiring, Sharon P. Andreoli, Lothar Bernd Zimmerhackl

Published in: Pediatric Nephrology | Issue 10/2008

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Abstract

Hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure in childhood and the reason for chronic renal replacement therapy. It leads to significant morbidity and mortality during the acute phase. In addition to acute morbidity and mortality, long-term renal and extrarenal complications can occur in a substantial number of children years after the acute episode of HUS. The most common infectious agents causing HUS are enterohemorrhagic Escherichia coli (EHEC)-producing Shiga toxin (and belonging to the serotype O157:H7) and several non-O157:H7 serotypes. D+ HUS is an acute disease characterized by prodromal diarrhea followed by acute renal failure. The classic clinical features of HUS include the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. HUS mortality is reported to be between 3% and 5%, and death due to HUS is nearly always associated with severe extrarenal disease, including severe central nervous system (CNS) involvement. Approximately two thirds of children with HUS require dialysis therapy, and about one third have milder renal involvement without the need for dialysis therapy. General management of acute renal failure includes appropriate fluid and electrolyte management, antihypertensive therapy if necessary, and initiation of renal replacement therapy when appropriate. The prognosis of HUS depends on several contributing factors. In general “classic” HUS, induced by EHEC, has an overall better outcome. Totally different is the prognosis in patients with atypical and particularly recurrent HUS. However, patients with severe disease should be screened for genetic disorders of the complement system or other underlying diseases.
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Metadata
Title
Treatment and outcome of Shiga-toxin-associated hemolytic uremic syndrome (HUS)
Authors
Johanna Scheiring
Sharon P. Andreoli
Lothar Bernd Zimmerhackl
Publication date
01-10-2008
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 10/2008
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-008-0935-6

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