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Hemolytic-uremic syndrome (HUS)
- Characterized by hemolytic anemia (pallor on exam), acute renal failure (oliguria or anuria by history), and thrombocytopenia (petechiae).
- HUS is one of the most common causes of acute renal failure in children.
- Two types: diarrhea-associated (shiga toxin+ or D+) which is more common and has a more favorable prognosis, and non diarrhea-associated (atypical or sporadic or D-).
- Most common age at presentation is during infancy or young childhood.
- Pediatric HUS is a true medical emergency.
- Resuscitation with blood products frequently is required, but it is crucial to provide volume carefully because renal function may be severely compromised.
- Dialysis is required if anuria persists for 12+ hours or for severe hyperkalemia (>6.5mEq/L) Some patients may benefit from plasmapheresis, but full renal recovery is not certain.