Long-Term Consequences of HUS Kidney Failure

Eric Hageman, lead attorney for our E. coli-HUS cases, discusses the long-term consequences of hemolytic uremic syndrome (HUS) in the article below. Eric and his team represent children throughout the United States. You can contact Eric using the following form.

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A study appearing in the prestigious Journal of the American Medical Association (JAMA) entitled “Long-term Renal Prognosis of Diarrhea-Associated Hemolytic Uremic Syndrome” analyzed almost 50 other journal articles on the subject and found that 25% of people who developed hemolytic uremic syndrome (HUS) had long-term kidney (renal) problems resulting from the disease.

There are three primary kidney complications: decreased glomerular filtration rate (GFR), hypertension, and/or proteinuria:

  • Decreased GFR: GFR is a test used to check how well the kidneys are working. Specifically, it estimates how much blood passes through the tiny filters in the kidneys called glomeruli every minute. The GFR test measures how well your kidneys are filtering a waste called creatinine, which is produced by the muscles. When the kidneys aren’t working as well as they should, creatinine builds up in the blood. According to the National Kidney Foundation, normal GFR results range from 90 – 120 mL/min. Older people will have lower normal GFR levels, because GFR decreases with age. Levels below 60 mL/min for 3 or more months are a sign of chronic disease. Those with GFR results below 15 mL/min are a sign of renal failure.
  • Hypertension: Hypertension is high blood pressure. In this context, it is usually defined as requiring antihypertensive medication or blood pressure measurement higher than the 90th percentile. Uncontrolled high blood pressure can lead to a number of  problems including artery damage, aneurysm, heart failure, stroke, and other serious problems. At a minimum, it requires medical monitoring and medication. Hypertension also increases the risk of further renal damage.
  • Proteinuria: Proteinuria is the presence of excessive amounts of protein in the urine. It occurs in the context of HUS as a result of decreased function. It is a sign of chronic disease.

If my child appears to have made a complete recovery, does that mean there will not be future kidney problems?

The usual measure of full recovery is a normal GFR. According to some studies, the presence of a normal GFR following acute HUS does not guarantee long-term renal health, although the data is far from conclusive. For example, in four studies of patients who apparently completely recovered after acute illness, anywhere from 8% to 61% went on to develop a lower-than-normal GFR, hypertension, or proteinuria during long-term follow-up.

Other studies, however, seem to indicate that full recovery following acute HUS means there will be no future complications. These studies are limited by follow-up times of five years or less which means that the full extent of future problems requires further study.

Are there problems other than kidney damage that my child may experience as a result of HUS?

Yes, other complications may include neurological deficits (acute and chronic), diabetes, and gastrointestinal problems.

Studies about the long-term problems associated with HUS kidney failure are inconsistent. For example, in one study of patients who had major neurological symptoms during their acute illness, on long-term follow-up they continued to show subtle neurological deficits including posturing, clumsiness, poor fine-motor coordination, hyperactivity, and distractibility.

A recent study involving adults with complications similar to HUS (thrombotic thrombocytopenic purpura (TTP)) noted that “After recovery, patients have significantly abnormal health-related quality of life; neurocognitive studies have documented deficits of attention, processing speed and memory, and also fatigue.”

A settlement for HUS from E. coli food poisoning should cover future medical expenses and cost of care. You can call our hemolytic uremic syndrome lawyers at 1-888-377-8900 (toll free). Attorney Eric Hageman represents clients nationwide in personal injury and wrongful death lawsuits.

Food Poisoning Attorneys Legal Team

Source: http://jama.ama-assn.org/cgi/content/full/290/10/1360.