Hemolytic Uremic Syndrome

Overview of Hemolytic Uremic Syndrome

Kidney diseases are an indication that kidneys are damaged and are unable to perform their function. When kidneys are damaged they cannot filter their blood properly. Diabetic and hypertensive patients are at a greater risk for kidney disease.

Hemolytic Uremic Syndrome occurs when the blood vessels of the kidneys are damaged. This causes the destruction of blood platelets and damaged and inflamed small blood vessels in the kidneys. It can also cause anemia.

The damage to the vessels can cause clotting in them, (also called thrombotic thrombocytopenic purpura) which causes the filtering system in the kidneys to fail, ultimately leading to kidney failure. It most commonly occurs in young children. This syndrome can be a result of bacterial invasion or other infections.

Prevalence of Hemolytic Uremic Syndrome

The highest incidence of hemolytic uremic syndrome occurs in Argentina. Germany, France, and Australia have an incidence rate of less than 1. This affects children from the ages of 4 months to 9 years in Pakistan.

 

Signs and Symptoms of Hemolytic Uremic Syndrome

Initial signs and symptoms of hemolytic uremic syndrome include:

When clots are formed in the blood vessels besides the inflammation, the following symptoms occur:

  • Extreme fatigue
  • Paleness
  • Shortness of breath
  • Blood in urine
  • Edema
  • Decreased urination
  • Bruising (unexplained)
  • Confusion
  • Seizures or stroke
  • Hypertension

Types of Hemolytic Uremic Syndrome

Causes of Hemolytic Uremic Syndrome

The main cause of hemolytic uremic syndrome is E. coli bacteria. Strains of this bacteria cause diarrhoea which produces Shiga Toxin. This toxin causes damage to the blood vessels. Other infections causing HUS to include:

  • HIV
  • Influenza 
  • Pneumococcal bacteria 
  • Anti-cancer medications
  • Immunosuppressants
  • Autoimmune disorder (rarely)
  • Genetics
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Risk Factors of Hemolytic Uremic Syndrome

Risk factors for this disease include:

  • Children aged from 4 months to 9 years
  • 65 years or older adults
  • Weak immune system
  • Genetic mutations
  • Contaminated meat
  • Contact with infected individuals

Health Complications of Hemolytic Uremic Syndrome

Complications arising due to hemolytic uremic syndrome include:

  • Hypertension
  • Kidney failure (acute or chronic)
  • Seizures
  • Heart problems
  • Gastrointestinal problems

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Prevention

Given below are some of the best possible preventive strategies for the uremic syndrome:

  • Do not frequent unclean swimming areas
  • Do not consume unpasteurized milk, juice, or other dietary liquids
  • Do not place raw and cooked meat in the same area
  • Make sure to properly wash hands before eating or cooking 
  • Make sure to properly clean your hands after using restrooms 
  • Make sure to properly cook the meat at a temperature of about 160 degrees Fahrenheit
  • Remember to defrost meat in the oven 
  • Keep your child away from swimming pools if they have diarrhea
  • Wash your hand after you have been in contact with an animal even if it’s your pet
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Diagnosis

A physical exam is performed and diagnostic tests are done to confirm hemolytic uremic syndrome, including:

Treatment of Hemolytic Uremic Syndrome | When to Consult a Doctor

HUS cannot be treated at home. The patient is hospitalized until the infection can be brought under control. Treatment methods include:

  • IV Fluids

Fluid loss and electrolyte imbalance are improved; this balances the electrolyte loss due to impaired kidney functioning.

  • Blood Transfusions

RBC’s and platelets are given through transfusion; this reverses the anaemia caused by HUS and platelets improve normal clotting in case of bleeding and bruising.

  • Medications

Medications to improve the symptoms of HUS are given and prevent further kidney damage.

  • Dialysis

Excess fluid and waste are filtered out of the body via dialysis. It is a temporary treatment that is done until the condition of the kidneys is improving.

  • Plasma Exchange

Fresh or donor plasma is given to clear the blood of its own plasma.

  • Kidney Transplant

If the dialysis and transfusions don’t work, a kidney transplant is the final treatment option available.

The hemolytic uremic syndrome occurs when the small blood vessels are damaged. It is difficult to diagnose any disease in small children. If any of the symptoms are observed and persistent, consult a nephrologist immediately.