Hemolytic-Uremic Syndrome Follow-up

Updated: Jul 02, 2021
  • Author: Malvinder S Parmar, MBBS, MS, FRCPC, FACP, FASN; Chief Editor: Srikanth Nagalla, MD, MS, FACP  more...
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Follow-up

Further Outpatient Care

Monitor kidney function and blood pressure, because as many as 80% of adults with hemolytic-uremic syndrome (HUS) require long-term dialysis or kidney 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.

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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, kidney function, and platelet counts.

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Transfer

The patient may need to be transferred to a tertiary care facility for specialized treatment (eg, plasma exchange, dialysis, intensive care unit monitoring).

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Deterrence/Prevention

Because typical 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 HUS and should be avoided unless they have septicemia. [39]

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