Hemolytic uremic syndrome (HUS)

Diagnosis

Diagnosing hemolytic uremic syndrome typically requires a series of tests and a thorough physical examination. Each test is designed to detect different markers indicative of the syndrome. When the cause of HUS is unclear, further tests may be performed to pinpoint the underlying factors contributing to the condition.

Tests that may be ordered include:

• Blood tests: During the procedure, a tiny needle is used to take a blood sample from an arm vein. Blood tests provide information on red blood cell and platelet levels, offering insights into kidney and liver functionality. The test can detect damage to the red blood cells.
• Urine test: This test searches for the presence of blood or protein in the urine. A urine sample is often collected through a container. A dipstick is then inserted into the jar. If there is blood or protein in the urine, the color of the dipstick will change.
• Fecal test: This test is conducted to identify the existence of E. coli O157, and a kidney biopsy is performed to reveal any damage to the kidneys.

Treatment

Fluid and mineral replacement

Treatment aims to mitigate reduced kidney function by replenishing lost fluids and minerals, a consequence of the kidneys’ diminished capacity to filter waste and excess fluids properly. Additionally, nutritional support is often administered intravenously to ensure the patient receives necessary sustenance.

Transfusions

• Red blood cells: To alleviate anemia symptoms, patients may receive red blood cell transfusions.
• Platelets: For those experiencing easy bleeding or bruising, platelet transfusions can enhance blood clotting.

Medications

• Blood pressure medication: To address potential lasting kidney damage, medications that lower blood pressure may be used to help prevent or slow further harm.
• Eculizumab: For atypical hemolytic uremic syndrome or complications, eculizumab can prevent additional blood vessel damage. Patients on eculizumab must be vaccinated against meningitis due to increased risk.

Surgical and other procedures

• Kidney dialysis: Temporarily replaces kidney function by removing waste and extra fluid from the blood. It’s used until the kidneys recover, though some may require long-term dialysis.
• Plasma exchange: This process involves replacing the patient’s plasma (the liquid part of blood) with fresh or frozen donor plasma to help circulate blood cells and platelets more effectively.
• Kidney transplant: In cases of severe kidney damage, a kidney transplant may be necessary.