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Early Intervention Key to Protecting Kidney Function in E. Coli O157: H7 Infection

the severity of hemolytic uremic syndrome (HUS) in children infected with Shiga toxin-producing Escherichia coli O157:H7, data from a small prospective cohort suggest. Children with HUS who did not receive IV fluid within the first 4 days of diarrhea onset were 60% more likely to develop oligoanuria (urine output 0.5 mL/kg/h for at least 1 day) compared with children who did receive early hydration, the researchers reported. This is significant, they said, because oligoanuria predicts greater severity of renal failure, longer hospitalizations, and higher frequency of chronic renal complications compared with nonoligoanuric HUS. “Because presence and/or duration of oligoanuria are so repeatedly associated with long-term sequelae in children with HUS, it seems appropriate to prioritize maintenance of urine output during HUS,” concluded Christina A. Hickey, MD, of Washington University School of Medicine in St. Louis, Missouri, and colleagues. “It is our hope that the benefit extends further, but right now we cannot state that pre-HUS IV volume expansion prevents long-term renal sequelae,” Hickey added in an interview.