Hemolytic (HEE-mo-LIT-ik) uremic (yoo-REE-mik) syndrome, or HUS, is one of the most common causes of sudden, short-term kidney failure in children. In severe cases, this acute kidney failure may require several sessions of dialysis to take over the kidneys' job of filtering wastes from the blood, but most children recover without permanent damage to their health.
Most cases of HUS occur after an infection of the digestive system by Escherichia coli bacterium, which is found in contaminated foods like meat, dairy products, and juice. Some people have contracted HUS after swimming in pools or lakes contaminated with feces. Washing and cooking foods adequately, avoiding undercooked meats, and avoiding unclean swimming areas are the best ways to protect your children from this disease.
The infection of the digestive tract is called gastroenteritis and may cause the child to vomit and have stomach cramps and bloody diarrhea. Most children who experience gastroenteritis recover fully in 2 or 3 days and do not develop HUS. In a few children, however, HUS develops when the bacteria lodged in the digestive system make toxins that enter the bloodstream and start to destroy red blood cells.
Symptoms of HUS may not become apparent until a week after the digestive problems. The child remains pale, tired, and irritable. Other symptoms include small, unexplained bruises or bleeding from the nose or mouth that may occur because the toxins also destroy the platelets, cells that normally help clotting.
You may notice that your child's urine output decreases. Urine formation slows because the damaged red blood cells clog the tiny blood vessels in the kidneys, making them work harder to remove wastes and extra fluid from the blood. The body's inability to rid itself of excess fluid and wastes may in turn cause high blood pressure or swelling of the face, hands, feet, or the entire body. This progression to acute kidney failure occurs in about half the cases of HUS.
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Healthy red blood cells (upper left) are smooth and round. In hemolytic uremic syndrome (lower right), toxins destroy red blood cells. These misshapen cells may clog the tiny blood vessels in the kidneys. |
Call your child's doctor immediately if you notice unexplained bruises, unusual bleeding, swollen limbs or generalized swelling, extreme fatigue, or decreased urine output in your child. You should call your doctor or visit an emergency room if your child goes 12 hours without urinating.
Treatments, which consist of maintaining normal salt and water levels in the body, are aimed at easing the immediate symptoms and preventing further complications. Blood transfusions (packed red blood cells) are sometimes necessary, and high blood pressure may need treatment. Only the most severe cases require dialysis. Some children may sustain significant kidney damage that slowly develops into permanent kidney failure and will then require long-term peritoneal dialysis or hemodialysis or a kidney transplant. Most children recover completely with no long-term consequences.
Some parents feel a sense of responsibility for their child's illness after a case of HUS. While the disease may ultimately have been preventable, caregivers should not feel guilty because the insidious course of the disease cannot be predicted from the initial bacterial infection, which many children experience without developing HUS. Caregivers who see that their children receive the appropriate medical care should rest assured that they have done all that any caring parent could do.
source: http://kidney.niddk.nih.gov/kudiseases/pubs/childkidneydiseases/hemolytic_uremic_syndrome/index.htm