Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Potential complications of haemolytic uraemic syndrome (HUS) to monitor in patients include:
- Acute kidney injury (AKI): This is the hallmark complication, often leading to oliguria or anuria and requiring close monitoring of renal function and fluid balance NICE CG84 Scheiring et al. 2010.
- Chronic kidney disease (CKD): Long-term renal impairment can develop, necessitating ongoing assessment of kidney function even after the acute phase NICE CG84 Yerigeri et al. 2023.
- Neurological complications: These may include seizures, stroke, altered mental status, or coma due to microvascular injury in the central nervous system (CNS) Scheiring et al. 2010 Formeck 2019.
- Cardiovascular involvement: Hypertension and cardiac dysfunction can occur secondary to volume overload and endothelial injury Formeck 2019 Yerigeri et al. 2023.
- Gastrointestinal complications: These include abdominal pain, pancreatitis, and bowel ischemia due to microthrombi formation Scheiring et al. 2010.
- Hematological issues: Persistent microangiopathic hemolytic anemia and thrombocytopenia may lead to bleeding or thrombotic events Scheiring et al. 2010.
- Extra-renal manifestations: Atypical HUS can involve multiple organs including the lungs, liver, and skin, reflecting systemic endothelial damage Formeck 2019 Yerigeri et al. 2023.
Close monitoring of renal function, neurological status, blood pressure, and hematological parameters is essential to detect and manage these complications promptly.
Key References
- CG84 - Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management
- CKS - Urinary tract infection (lower) - women
- CKS - Infertility
- CKS - Coeliac disease
- CKS - Gastroenteritis
- NG203 - Chronic kidney disease: assessment and management
- NG228 - Subarachnoid haemorrhage caused by a ruptured aneurysm: diagnosis and management
- NG240 - Meningitis (bacterial) and meningococcal disease: recognition, diagnosis and management
- (Scheiring et al., 2010): Clinical practice. Today's understanding of the haemolytic uraemic syndrome.
- (Formeck and Swiatecka-Urban, 2019): Extra-renal manifestations of atypical hemolytic uremic syndrome.
- (Yerigeri et al., 2023): Atypical Hemolytic-Uremic Syndrome: Genetic Basis, Clinical Manifestations, and a Multidisciplinary Approach to Management.