Hemolytic uremic syndrome (HUS) is defined by the presence of microangiopathic hemolytic anemia (this type of anemia is caused by the destruction of red blood cells through trauma to small blood vessels), thrombocytopenia (caused by a decrease in the number of platelets in the bloodstream), and acute kidney injury (rapid loss of kidney function due to kidney damage).
The most common form of HUS is that associated with Shiga toxin-producing Escherichia coli (STEC) or SHU-STEC infection, which mainly affects children. STEC-HUS is a leading cause of acute kidney injury in children worldwide.
Approximately 1.5-3% of children with STEC-HUS die during the acute phase of the disease and about 30% experience long-term renal sequelae. Argentina is the country with the highest incidence of STEC-HUS in the world. In this country, this disease is endemic; it accounts for approximately 95% of all HUS cases.
At present, there is no specific treatment capable of preventing or controlling renal and extrarenal damage caused by Shiga toxin. Treatment of HUS-STEC is symptomatic, meaning that the symptoms are treated directly, which usually include vomiting, poor urine output and bloody diarrhea. Therapy for patients with acute kidney injury is supportive and includes fluid and electrolyte management; 40% to 60% of cases require hemodialysis. In addition, as patients present with anemia and thrombocytopenia and other non-renal complications, they often require red blood cell or platelet transfusions and ICU care.
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