Abstract
Objective: To ascertain the role of serum potassium levels in predicting clinical outcomes in diarrhea-associated hemolytic uremic syndrome (HUS D+). Methods: We reviewed clinical and laboratory data from HUS D+ patients at our tertiary care institution from 2001 to 2008. Serum potassium concentration at presentation and during the acute phase of acute renal failure were recorded and related to laboratory parameters and clinical outcomes. Results: 15 HUS D+ cases were identified. E. coli 0157:H7 was found in 9/15 cases (70%). Potassium levels were not predictive of clinical outcomes. Normal serum potassium levels were found in the majority of patients. Potassium levels <3.6 mmol/L were evident at presentation in 3/15 patients (23%), and no patient manifested hyperkalemia even when creatinine levels were concurrently increase. Conclusions: This study suggests the presence of vigorous compensatory mechanisms in the homoestasis of serum potassium levels during HUS D+ disease since neither the increase stool volumes associated with diarrhea nor the presence of renal failure resulted in clinically significant changes in serum potassium levels.
Highlights
Hemolytic-Uremic Syndrome (HUS) is defined by the triad of microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure
We reviewed clinical and laboratory data from HUS D+ patients at our tertiary care institution from 2001 to 2008
This study suggests the presence of vigorous compensatory mechanisms in the homoestasis of serum potassium levels during HUS D+ disease since neither the increase stool volumes associated with diarrhea nor the presence of renal failure resulted in clinically significant changes in serum potassium levels
Summary
Hemolytic-Uremic Syndrome (HUS) is defined by the triad of microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. HUS is a heterogeneous group of similar entities characterized by a variety of prothrombotic host abnormalities [3], with variable clinical expression and severity [4,5]. It is often associated with diarrhea (HUS D+) caused by gastrointestinal infections with Shiga toxin-producing E. coli, which likely produce their effect through the systemic spread of bacterial derived toxins [6,7]. HUS is the most frequent cause of non-pre-renal acute renal failure in pediatrics. We sought to examine potassium levels in patients with HUS D+ at our institution in an attempt to do understand the pathophysiology of potassium metabolism in HUS D+
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