HEMOLYTIC-UREMIC SYNDROME – WHEN TO START HEMODIALYSIS

Abstract

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.