Treatments and drugsBy Mayo Clinic staff
Hemolytic uremic syndrome requires treatment in the hospital. To ease immediate signs and symptoms and prevent further problems, hemolytic uremic syndrome treatment may include:
- Fluid replacement. Lost fluid and electrolytes need to be carefully replaced because the kidneys aren't removing fluids and waste as efficiently as normal.
- Red blood cell transfusions. If you don't have enough red blood cells, you may feel chilled, fatigued and short of breath. You may have a rapid heart rate, yellow skin and dark urine. Red blood cell transfusions, given through an intravenous (IV) needle, may help reverse these signs and symptoms.
- Platelet transfusions. If you're bleeding or bruising easily, platelet transfusions can help your blood clot more normally. Like red blood cell transfusions, platelet transfusions are given through an IV needle.
- Plasma exchange. Plasma is the part of blood that supports the circulation of blood cells and platelets. Sometimes a machine is used to clear the blood of its own plasma and replace it with fresh or frozen donor plasma. This process is called plasmapheresis.
- Kidney dialysis. Sometimes dialysis is needed to filter waste and excess fluid from the blood. Dialysis is usually a temporary treatment until the kidneys begin functioning adequately again. If the kidney damage is significant, however, permanent kidney failure — requiring long-term dialysis or a kidney transplant — is possible.
Despite the severity of the condition, appropriate treatment leads to a full recovery for most people with hemolytic uremic syndrome — especially young children.
In those who have some lasting kidney damage, following a low-protein diet and taking the blood pressure lowering medications known as angiotensin-converting enzyme (ACE) inhibitors if blood pressure is high may prevent or delay further kidney damage.
A less common type of hemolytic uremic syndrome called atypical hemolytic uremic syndrome also is treated with plasma exchange. The Food and Drug Administration has approved the use of a medication called eculizumab (Soliris) for the treatment of atypical hemolytic uremic syndrome. Eculizumab is a type of medication known as a monoclonal antibody. It prevents the continued destruction of healthy cells. However, this medication has a significant risk of serious infection. If possible, you or your child may receive the meningococcal vaccine before receiving this medication.
- Niaudet P. Clinical manifestations and diagnosis of Shiga toxin associated (typical) hemolytic uremic syndrome in children. http://www.uptodate.com/home. Accessed May 26, 2013.
- Tintinalli JE, et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=40. Accessed May 26, 2013.
- Bavaro MF. E. coli O157:H7 and other toxigenic strains: The curse of global food distribution. Current Gastroenterology Reports. 2012;14:317.
- Thrombotic thrombocytopenic purpura (TTP) and hemolytic-uremic syndrome. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec11/ch133/ch133g.html. Accessed May 26, 2013.
- Hemolytic uremic syndrome in children. National Kidney and Urologic Diseases Information Clearinghouse . http://kidney.niddk.nih.gov/KUDiseases/pubs/childkidneydiseases/hemolytic_uremic_syndrome/. Accessed May 21, 2013.
- Bielaszewska M, et al. Enterohemorrhagic escherichia coli O26:H11/H-: A new virulent clone emerges in Europe. Clinical Infectious Diseases. 2013;56:1373.
- George JN. Causes of thrombotic thrombocytopenic purpura-hemolytic uremic syndrome in adults. http://www.uptodate.com/home. Accessed May 26, 2013.
- Elliott MM, et al. Interventions for haemolytic uraemic syndrome and thrombotic thrombocytopenic purpura. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003595.pub2/abstract. Accessed May 26, 2013.
- Food safety. Centers for Disease Control and Prevention. http://www.cdc.gov/foodsafety/facts.html. Accessed May 26, 2013.
- Niaudet P. Treatment and prognosis of Shiga toxin associated (typical) hemolytic uremic syndrome in children. http://www.uptodate.com/home. Accessed May 26, 2013.
- Niaudet P. Atypical hemolytic uremic syndrome in children. http://www.uptodate.com/home. Accessed May 26, 2013.
- Nester CM, et al. Atypical hemolytic uremic syndrome: What is it, how is it diagnosed, and how is it treated? Hematology. 2012;2012:617.
- Ground beef and food safety. U.S. Department of Agriculture. http://www.fsis.usda.gov/factsheets/ground_beef_and_food_safety/. Accessed May 28, 2013.
- Hunt JM. Shiga toxin-producing Escherichia coli (STEC). Clinics in Laboratory Medicine. 2010;30:21.