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What is hemolytic uremic syndrome?

Hemolytic uremic syndrome (HUS) is a rare condition that can lead to kidney failure in children. Kidney failure develops as a result of destruction of the small structures and vessels inside the kidney.

HUS is a serious illness and potentially fatal.

Symptoms & Causes

What are the symptoms of hemolytic uremic syndrome?

Each child may experience symptoms differently, but we’ve put together a list of some common ones.

Initial symptoms

The initial symptoms of HUS frequently last from one to 15 days and may include symptoms in the digestive tract such as the following:

Severe problems in the bowel and colon

In these cases, even if the digestive symptoms are no longer present, your child may still exhibit the following symptoms:

Your child may produce little urine because damaged red blood cells and other factors may clog the tiny blood vessels in the kidneys, or cause lesions in the kidneys, making them work harder to remove wastes and extra fluid.

Symptoms caused by fluid retention

The body's inability to rid itself of excess fluid and waste may, in turn, cause the following symptoms:

The symptoms of hemolytic uremic syndrome may resemble other medical conditions or problems. Always consult your child's physician for a diagnosis.

What causes hemolytic uremic syndrome?

  • Typically in children, HUS develops after a child is infected with the E. coli bacterium. E. coli may be found in contaminated food such as dairy products and meat.
  • HUS can also develop as a result of taking certain medications, or may result from a cancer present in the body, although these causes are less common.
  • Some rare cases of HUS are familial, which suggests a genetic cause.

HUS is more common during the summer months and may occur in outbreaks. Outbreaks have been reported in daycare centers, water parks, and fast food restaurants as a result of undercooked hamburger meat.

HUS is most common in younger children between 6 months and 4 years, but can occur at any age.

Diagnosis & Treatments

How is hemolytic uremic syndrome diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for hemolytic may include:

  • Blood tests: to check blood cell counts, electrolytes and kidney function
  • Urine tests: to check for blood and protein
  • Stool tests: to check for blood
  • Abdominal X-ray: a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

How is hemolytic uremic syndrome treated?

There is no known treatment that can stop the progression of HUS once it has started.

Initially, treatment may be supportive, which means that your child's doctor will treat the symptoms. If your child shows signs of dehydration and electrolyte irregularities, these conditions will be treated first.

Other therapies may include:

  • Intensive care: Close observation and monitoring in an intensive care unit (ICU) may be necessary.
  • Blood transfusions: Blood transfusions may be necessary to treat anemia (low red blood cell count).
  • Nutrition: Your child may require intravenous nutrition if he or she is having severe digestive tract complications.
  • Dialysis: Dialysis may be required in up to half of all children who develop HUS. Dialysis is a medical procedure to remove wastes and additional fluid from the blood after the kidneys have stopped functioning.
  • Medication: Medications may be required to treat your child's blood pressure, which may be elevated.

Can hemolytic uremic syndrome be prevented?

  • Completely cooking all foods that may contain hamburger meat can prevent HUS that is caused by E. coli.
    • About 2 percent to 7 percent of children with an E. coli infection are likely to develop HUS.
    • Other possible sources of E. coli include unpasteurized juices or milk.

If your child has HUS, it's important to notify your daycare center or your child's other close contacts (such as play groups and school). HUS isn't contagious, but spread of the E. coli bacterium is contagious.

How we care for HUS

The End-Stage Renal Program at Boston Children's Hospital consists of an expert team of physicians, surgeons, nurses, nutritionists and social workers who assist children with chronic renal failure.

We work with families to plan individualized therapy for each child.

Our goal is to preserve each patient's growth and development by integrating schooling and providing guidance on behavioral and financial issues. We also assist in arranging transport and home help support, as well as visiting nursing services.

Research & Clinical Trials

Our areas of innovation for hemolytic uremic syndrome

In the rare event that your child requires a kidney transplant, researchers at the Kidney Transplant Program at Children’s are constantly working to improve the process of transplantation — and the results.

Anti-rejection research

Researchers in the Children’s Kidney Transplant Program lead the global development of and participation in pediatric kidney transplant clinical research.

We are committed to developing innovative and improved anti-rejection medication protocols with the goal of more successful transplants and reduced side effects and complications.

As a result of trials managed through our center, certain steroids have been eliminated from post-transplant treatment plans for some children.

National Institutes of Health research programs

We currently participate in more NIH-sponsored pediatric kidney transplant research studies than any other program in the nation.

Additional information about our research is available on our research Web site, including a list of transplant studies currently enrolling eligible patients.

Transplant Research Center (TRC)

In 2003, in an effort to speed the knowledge and results gained from research into innovative and improved approaches to the care of transplant patients, Boston Children’s Hospital and Brigham and Woman's Hospital founded the Transplantation Research Center (TRC).

The TRC provides a rich environment for collaboration of scientists and physicians from both institutions in the areas of transplantation and immunology.

The TRC , in conjunction with Children’s Pediatric Transplant Center (PTC) — one of the most advanced and comprehensive transplant centers in the country — reaffirm Children's collaborative "bench-to-bedside" philosophy of care.

Practitioners Who Specialize In This Condition (5)

Amar Majmundar, MD, PhD

Amar Majmundar, MD, PhD

Co-Director, Kidney Genetics Clinic; Nephrologist, Division of Nephrology
Assistant Professor of Pediatrics, Harvard Medical School
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