HEMOLYTIC-UREMIC SYNDROME – WHEN TO START HEMODIALYSIS
DOI:
https://doi.org/10.52340/jecm.2023.02.09Ключевые слова:
Hemolytic-uremic syndrome, acute kidney injury, hemodialysisАннотация
Intestinal infections have always been and remain an urgent problem in medicine. Often bloody diarrhea (hemocolitis) is the first manifestation of hemolytic-uremic syndrome (HUS), characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. Treatment is supportive, hemodialysis needs is in list of treatment. There are no specific criteria for determining when to start hemodialysis sessions if HUS is diagnosed. The article presents the cases when hemodialysis was started in various stages of duration HUS. Based on literary sources and our experience, we believe that specifically in the case of hemolytic-uremic syndrome:
- Considering the expected results, starting hemodialysis (invasive manipulation) as soon as the diuresis decreases (the amount of urine secreted within six hours ≤ 0.5 ml/kg) provides more benefits than starting the manipulation after the manifestation of „traditional“ (life threatening findings) indications for dialysis.
- In our case, this way of managing the patient was much less stressful, significantly cost-effective and successful.
Скачивания
Библиографические ссылки
Mody, R.K.; Gu, W.; Griffin, P.M.; Jones, T.F.; Rounds, J.; Shiferaw, B.; Tobin-D’Angelo, M.; Smith, G.; Spina, N.; Hurd, S.; et al. Postdiarrheal hemolytic uremic syndrome in United States children: Clinical spectrum and predictors of in-hospital death. J. Pediatr. 2015, 166, 1022–1029.
Wong, C.S.; Mooney, J.C.; Brandt, J.R.; Staples, A.O.; Jelacic, S.; Boster, D.R.; Watkins, S.L.; Tarr, P.I. Risk factors for the hemolytic uremic syndrome in children infected with Escherichia coli O157:H7: A multivariable analysis. Clin. Infect. Dis. 2012, 55, 33–41.
Trachtman, H.; Austin, C.; Lewinski, M.; Stahl, R.A. Renal and neurological involvement in typical Shiga toxin-associated HUS. Nat. Rev. Nephrol. 2012, 8, 658–669.
Bellomo R, Ronco C, Kellum JA et al. Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: The Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004; 8: R204–212.
Sever MS, Kellum J, Hoste E et al. Application of the RIFLE criteria in patients with crush-related acute kidney injury after mass disasters. Nephrol Dial Transplant 2011; 26: 515–524.
Zhi-Hao Zhang, Jia-Rong Mao, Hua Chen, Wei Su, Yuan Zhang, Li Zhang, Dan-Qian Chen, Ying-Yong Zhao, Nosratola D Vaziri, Removal of uremic retention products by hemodialysis is coupled with indiscriminate loss of vital metabolites, ClinBiochem. 2017 Dec; 50(18):1078-1086. doi: 10.1016/j.clinbiochem.2017.09.012. Epub 2017 Sep 18.
Maccariello E, Soares M, Valente C, Nogueira L, Valença RVR, Machado J, et al. RIFLE classification in patients with acute kidney injury in need of renal replacement therapy. Intens Care Med. 2007;33:479–605
Coad NA, Marshall T, Rowe B, Taylor CM. Changes in the post-enteropathic form of the hemolytic uremic syndrome in children. ClinNephrol. 1991;35:10–16
Loirat C, Garnier A, Sellier-Leclerc AL, Kwon T. Plasmatherapy in atypical hemolytic uremic syndrome. SeminThrombHemost. 2010;36:673–681.
Trachtman H, Austin C, Lewinski M, Stahl RA. Renal and neurological involvement in typical Shiga toxin-associated HUS. Nat Rev Nephrol 2012; 8: 658– 69.
Lee JE, Kim JS, Choi IH, Tagawa M, Kohsaka T, Jin DK. Cytokine expression in the renal tubular epithelial cells stimulated by Shiga toxin 2 of Escherichia coli O157:H7. Ren Fail 2002; 24 (5): 567– 75.
Загрузки
Опубликован
Как цитировать
Выпуск
Раздел
