What are the Expected Short and Long-term Outcomes for Patients with Post-Diarrheal Hemolytic Uremic Syndrome?
The natural history (clinical course) of post-diarrheal hemolytic uremic syndrome (D+HUS) improved remarkably with the advent of kidney dialysis and intensive care facilities for children. What was originally (in the 1950’s) a 40 percent death rate is now only 3 to 5 percent in developed countries. Patients today rarely die directly from the acute renal failure, and when death occurs, it is almost always due to our inability to prevent, recognize and effectively treat life-threatening extra renal organ injury. Although brain damage is the single most common cause of death, severe multi-organ damage (e.g., renal cortical necrosis, bowel necrosis and stroke) is common in fatal cases. Survivors usually escape immediate serious sequelae, but about 3-5 percent are left with long-term extra-renal damage, especially of the pancreas or brain. An equal number are left with severe kidney damage, and require chronic dialysis and kidney transplant from the start or after only a few years. A much l
