10.3 Hemolytic Uremic Syndrome

Question 1

Hemolytic Uremic Syndrome (HUS)

Answer 1

• Usually caused by E-Coli

Other Causes
- Shiga Toxin
- Contaminated Food/Water
- Bacteria/Viruses/Chemicals

TRIAD OF SYMPTOMS
- Acute Renal Failure
- Hemolytic Anemia
- Thrombocytopenia

Question 2

Pathophysiology of HUS

Answer 2

• Typically a causative agent (preceding infection most likely E-Coli)
• This preceding infection causes swelling of endothelium of glomerulus which results in acute renal failure.
• RBCs are damaged as they pass through the swelled glomerular capillaries which cause hemolytic anemia
• Platelets aggregate and become damaged which results in thrombocytopenia

S/S
- Prodromal period of diarrhea/vomiting from their previous infection
- Bruising, Petechiae, Bloody Stool (from thrombocytopenia)
- Oliguria or Anuria (from renal failure)
- Seizures due to electrolyte imbalance

Treatment
- Nutritional support
- Antihypertensives (because they are not filtering properly)
- IV Fluids
- Blood Transfusions
- Dialysis
- Platelet Replacement

Nursing Care
- Monitor I&O
- Daily Weights
- Vitals (to check if infection is still lingering)

Question 3

Shiga Toxin

Answer 3

• Toxin that damages capillary lining
• Platelets clump to the area to try and stop blood loss and initiate healing
• Platelets mesh in the capillaries which damages RBCs, prevents adequate blood flow to affected organs, resulting in organ dysfunction or failure