Hemolytic-Uremic Syndrome Follow-up
- Author: Malvinder S Parmar, MB, MS; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP more...
Further Outpatient Care
Monitor renal function and blood pressure, because as many as 80% of adults with hemolytic-uremic syndrome (HUS) require long-term dialysis or renal transplantation.
Ensure adequate blood pressure control and consider renin-angiotensin blockade with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers.
Early protein restriction may be needed in patients who develop residual chronic kidney disease after the acute phase.
Further Inpatient Care
Provide nutritional support during the acute illness in patients with hemolytic-uremic syndrome (HUS). Some children with gastrointestinal involvement may require prolonged parenteral feeding. Closely monitor electrolyte levels, renal function, and platelet counts.
The patient may need to be transferred to a tertiary care facility for specialized treatment (eg, plasma exchange, dialysis, ICU monitoring).
Because typical hemolytic-uremic syndrome (HUS) commonly occurs in epidemics, consider this possibility and inform health authorities to monitor for the possibility of index cases and to prevent the spread of disease in the community.
At present, prevention is the main approach to decreasing the morbidity and mortality associated with Stx-E coli infection.
Antibiotic treatment of children with E coli O157:H7 infection increases the risk of hemolytic-uremic syndrome (HUS) and should be avoided unless they have septicemia.
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