WHAT YOU NEED TO KNOW:

What is hemolytic uremic syndrome? HUS occurs when a toxic substance is released into your bloodstream and destroys red blood cells. This causes bleeding, blood clots, and kidney damage.

What causes hemolytic uremic syndrome? Food that contains bacteria is the most common cause of HUS. An example is E. coli bacteria. The bacteria release harmful substances that injure blood vessels. The following can also cause HUS:

• Bone marrow transplant
  
  
• Cancer or chemotherapy
  
  
• Conditions that affect the immune system, such as lupus or HIV
  
  
• Certain medicines used to treat heart disease, clotting disorders, or diarrhea
  
  
• Pregnancy

What are the signs and symptoms of hemolytic uremic syndrome?

• Abdominal pain, vomiting, and diarrhea
  
  
• Bleeding from the lips, mouth, or nose
  
  
• Coughing and trouble breathing
  
  
• Little or no urine, or blood in the urine
  
  
• Fever
  
  
• High blood pressure
  
  
• Pale or blue skin, lips, or nails
  
  
• Pinpoint reddish spots, or purple bruises

How is hemolytic uremic syndrome diagnosed?

• Blood tests: Your blood is tested for signs of kidney damage or infection.
  
  
• Urine test: Your urine is tested for signs of kidney damage. You may also need to collect all of your urine for 24 hours for testing. This longer test gives more detailed information about your kidney function.
  
  
• Bowel movement sample: A sample of your bowel movement is tested for the germ that is causing your illness. This helps healthcare providers decide the best medicine to treat you.
  
  
• Percutaneous kidney biopsy: A percutaneous kidney biopsy is when a very small piece of your kidney is taken out and tested. For this procedure, you will need to lie face-down and hold very still. You may get medicine to help you relax before the biopsy. You may also get medicine to make the area numb (lose feeling) before the needle is put in. Caregivers put a needle into your back and through to your kidney. The needle has a sharp edge that will cut out a tiny piece of your kidney. The needle may have to be put in two or more times. After the needle is taken out, a bandage will be put over the area.

How is hemolytic uremic syndrome treated?

• IV fluids: This helps to maintain the fluid and salt balance in your body.
  
  
• Medicines: You may need medicines, such as anticonvulsants, steroids, and blood pressure medicine to help control the symptoms of HUS. Ask your healthcare provider about any medicines you may need.
  
  
• Blood transfusion: You will get whole or parts of blood through an IV during a transfusion. Blood is tested for diseases, such as hepatitis and HIV, to be sure it is safe.
  
  
• Dialysis: Dialysis cleans your blood when your kidneys cannot. Extra water, chemicals, and waste products are removed from your blood by a dialyzer or dialysis machine. The dialysis machine does this by passing your blood through a special filter, then returning it back to you. You may need dialysis for a short time, or for the rest of your life. Caregivers will check your vital signs often during dialysis. You may also be given medicines or have blood taken for lab tests during dialysis.
  
  
• Plasma exchange: Blood is drawn through an IV. A machine separates the plasma from your blood cells. Your plasma is then taken out and replaced by donor plasma or albumin. The blood cells, together with the replacement plasma or albumin, are then put back into your body through the IV.
  
  
• Kidney transplant: You may need a kidney transplant if you have kidney failure.

What are the risks of hemolytic uremic syndrome? Left untreated, HUS can cause kidney failure. HUS may lead to life-threatening problems. Blood clots may block small blood vessels and affect other parts of your body. Blocked intestines, muscle destruction, and swelling of the pancreas may occur. Long-term effects of HUS include high blood pressure and uremia (too much nitrogen in the body).

When should I contact my healthcare provider?

• You have a fever.
  
  
• You have bleeding from your gums, lips, or nose.
  
  
• You have bloody or dark urine or bowel movements.
  
  
• You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

• You are urinating less than usual or not at all.
  
  
• You have diarrhea and vomiting.
  
  
• You have severe abdominal pain.
  
  
• You have a severe headache, trouble thinking, and are confused.
  
  
• You have trouble seeing.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.