World Journal of Pediatrics

, Volume 13, Issue 2, pp 183–185 | Cite as

Clinical characteristics of children with hemolytic uremic syndrome in Hangzhou, China

  • Shui-Ai Zhao
  • Bo-Tao Ning
  • Jian-Hua Mao
Original Article



Hemolytic uremic syndrome (HUS) is a main cause of acute renal failure in children. This study aimed to analyze the clinical characteristics of HUS.


A retrospective analysis was performed in 46 children with sporadic HUS.


Of the 46 HUS patients, 20 (43.5%) were diarrhea-related HUS, and 26 (56.5%) were atypical HUS. Anemia, edema, oliguria, hemoglobinuria and hypertension were the most common manifestations. Thrombocytopenia, hyponatremia, hypocalcemia, hyperkalemia, metabolic acidosis, increased fibrinogen and hypocomplementemia were found in most patients. The age of onset (younger than 2 years or not, P=0.009), the duration of oliguria or anuria (more than one week or not, P=0.005), accompanied with extrarenal complications or not (P=0.005), dialysis and plasma exchange (P=0.04) were associated with the mortality rate.


The age of onset younger than 2 years, oliguria/anuria more than 1 week, and associated with extrarenal complications were predictive factors of poor prognosis.

Key words

hemolytic uremic syndrome prognosis therapy 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Tserenpuntsag B, Chang HG, Smith PF, Morse DL. Hemolytic uremic syndrome risk and Escherichia coli O157:H7. Emerg Infect Dis 2005;11:1955–1957.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Rock G, Kolajova M, Faught C, Zimmerman D. Identification of plasma antifibrin/fibrinogen antibodies in a patient with hemolytic uremic syndrome. Blood Coagul Fibrinolysis 2006;17:539–544.CrossRefPubMedGoogle Scholar
  3. 3.
    Zhang Y, Meng Q, Zhou C. The epidemic survey of children with hemolytic uremic syndrome (HUS), analysis of the death patients and therapeutic advance in 35 years in Beijing Children’s Hospital. J Clin Pediatr (Chinese) 2003;21:545–548. [In Chinese]Google Scholar
  4. 4.
    Roumenina LT, Roquigny R, Blanc C, Poulain N, Ngo S, Dragon-Durey MA, et al. Functional evaluation of factor H genetic and acquired abnormalities: application for atypical hemolytic uremic syndrome (aHUS). Methods Mol Biol 2014;1100:237–247.CrossRefPubMedGoogle Scholar
  5. 5.
    Fakhouri F, Hourmant M, Campistol JM, Cataland SR, Espinosa M, Gaber AO, et al. Terminal complement inhibitor eculizumab in adult patients with atypical hemolytic uremic syndrome: a single-arm, open-label trial. Am J Kidney Dis 2016;68:84–93.CrossRefPubMedGoogle Scholar
  6. 6.
    Nakatani T, Tsuchida K, Yoshimura R, Sugimura K, Takemoto Y. Plasma exchange therapy for the treatment of Escherichia coli O-157 associated hemolytic uremic syndrome. Int J Mol Med 2002;10:585–588.PubMedGoogle Scholar
  7. 7.
    Slavicek J, Puretic Z, Novak M, Sarnavka V, Benjak V, Glavas-Boras S, et al. The role of plasma exchange in the treatment of severe forms of hemolytic-uremic syndrome in childhood. Artif Organs 1995;19:506–510.CrossRefPubMedGoogle Scholar
  8. 8.
    Cobenas CJ, Alconcher LF, Spizzirri AP, Rahman RC. Longterm follow-up of Argentinean patients with hemolytic uremic syndrome who had not undergone dialysis. Pediatr Nephrol 2007;22:1343–1347.CrossRefPubMedGoogle Scholar
  9. 9.
    Bhimma R, Coovadia HM, Adhikari M, Connolly CA. Reevaluating criteria for peritoneal dialysis in "classical" (D+) hemolytic uremic syndrome. Clin Nephrol 2001;55:133–142.PubMedGoogle Scholar
  10. 10.
    Mody RK, Gu W, Griffin PM, Jones TF, Rounds J, Shiferaw B, et al. Postdiarrheal hemolytic uremic syndrome in United States children: clinical spectrum and predictors of in-hospital death. J Pediatr 2015;166:1022–1029.CrossRefPubMedGoogle Scholar
  11. 11.
    Kawasaki Y, Suyama K, Maeda R, Yugeta E, Takano K, Suzuki S, et al. Incidence and index of severity of hemolytic uremic syndrome in a 26 year period in Fukushima Prefecture, Japan. Pediatr Int 2014;56:77–82.CrossRefPubMedGoogle Scholar
  12. 12.
    Gianviti A, Tozzi AE, De Petris L, Caprioli A, Rava L, Edefonti A, et al. Risk factors for poor renal prognosis in children with hemolytic uremic syndrome. Pediatr Nephrol 2003;18:1229–1235.CrossRefPubMedGoogle Scholar

Copyright information

© Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of Nephrology, Children’s HospitalZhejiang University School of MedicineHangzhouChina
  2. 2.Department of PICU, Children’s HospitalZhejiang University School of MedicineHangzhouChina

Personalised recommendations