U.S. Department of Health 

and Human Services 

 

 

 

 

 

 

 

 

 

 

Hemolytic Uremic 

Syndrome in Children 

What is hemolytic uremic 

syndrome (HUS)? 

HUS, a disease that destroys red blood 

cells, is the most common cause of sudden, short-term—acute—kidney failure in 

children. Although HUS can cause serious 

complications and can even be life threatening, most children who develop HUS 

recover without permanent damage to 

their health. 

What causes HUS? 

HUS develops when Escherichia coli 

(E. coli) bacteria lodged in the digestive 

tract make toxins that enter the bloodstream and start to destroy red blood cells. 

Most cases of HUS occur after an infection 

of the digestive tract by the E. coli bacterium, which is found in foods like meat, 

dairy products, and juice when they are 

contaminated. Some people have contracted HUS after swimming in pools or lakes 

contaminated with feces. 

NATIONAL INSTITUTES OF HEALTH 

National Kidney and Urologic Diseases 

Information Clearinghouse 

Healthy red blood cells (left) are smooth and round. In hemolytic uremic syndrome, toxins destroy red 

blood cells (right). These misshapen cells may clog the tiny blood vessels in the kidneys. 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Infection of the digestive tract is called gastroenteritis and may cause a child to vomit and have stomach 

cramps and bloody diarrhea. Most children who 

have gastroenteritis recover fully in 2 or 3 days and 

do not develop HUS. 

What are the signs and symptoms of 

HUS and kidney failure? 

With HUS, the child remains pale, tired, and irritable. Other signs include small, unexplained bruises 

or bleeding from the nose or mouth that may occur 

because the toxins also destroy the platelets, cells 

that normally help the blood to clot. Signs and 

symptoms of HUS may not become apparent until a 

week after the digestive problems have occurred. 

More than half of children with HUS develop acute 

kidney failure. With kidney failure, the child’s urine 

output decreases. The urine may also appear red. 

Urine formation slows because the damaged red 

blood cells clog the tiny blood vessels in the kidneys, 

making them work harder to remove wastes and 

extra fluid from the blood. The body’s inability to 

rid itself of excess fluid and wastes may in turn cause 

high blood pressure or swelling of the face, hands, 

feet, or entire body. 

Parents or guardians should call the child’s doctor 

immediately if the child has unexplained bruises, 

unusual bleeding, swollen limbs or generalized 

swelling, extreme fatigue, or decreased urine output. 

A child who goes 12 hours without urinating should 

be taken to a doctor or an emergency room. 

How is HUS diagnosed? 

A doctor may suspect that a child has HUS after 

examining the child and learning the history of 

symptoms. The diagnosis is confirmed by microscopic examination of a blood sample to see if the 

red blood cells are misshapen. 

How is HUS treated? 

Treatments, which consist of maintaining normal salt 

and water levels in the body, are aimed at easing the 

immediate symptoms and preventing further problems. A child may need a transfusion of red blood 

cells delivered through an intravenous, or IV, tube. 

In severe cases, several sessions of dialysis, a bloodcleansing treatment, may be required to temporarily 

take over the kidneys’ job of filtering wastes and 

extra fluid from the blood. 

Some children may sustain significant kidney damage that slowly develops into permanent kidney 

failure and will then require long-term dialysis or a 

kidney transplant. Some studies suggest that limiting protein in the child’s diet and treating high blood 

pressure with a medicine from a class of drugs called 

angiotensin-converting enzyme (ACE) inhibitors 

helps delay or prevent the onset of permanent kidney 

failure. Most children recover completely with no 

long-term consequences. 

How can HUS be prevented? 

Washing and cooking foods adequately, especially 

meats, and avoiding unclean swimming areas are the 

best ways to protect a child from this disease. 

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Points to Remember 

n	 Hemolytic uremic syndrome (HUS), a disease 

that destroys red blood cells, is the most common 

cause of sudden, short-term—acute—kidney failure in children. 

n	 Although HUS can cause serious complications 

and can even be life threatening, most children 

with HUS recover without permanent damage to 

their health. 

n	 Most cases of HUS occur after an infection of 

the digestive tract by Escherichia coli (E. coli) 

bacterium, which is found in foods like meat, 

dairy products, and juice when they are 

contaminated. 

n	 Treatments, which consist of maintaining normal 

salt and water levels in the body, are aimed at 

easing the immediate symptoms and preventing 

further problems. 

n	 A child may need a transfusion of red blood cells 

delivered through an intravenous, or IV, tube. 

n	 Only the most severe cases require dialysis. 

Hope through Research 

The National Institute of Diabetes and Digestive and 

Kidney Diseases (NIDDK) conducts and supports 

research to help people of all ages with kidney disease, including children. The NIDDK’s Division of 

Kidney, Urologic, and Hematologic Diseases (KUH) 

maintains the Pediatric Nephrology Program, which 

supports research into the causes, treatment, and 

prevention of kidney diseases in children. The KUH 

division supports several researchers working to find 

ways to prevent HUS from developing after the initial infection of the digestive tract. 

Participants in clinical trials can play a more active 

role in their own health care, gain access to new 

research treatments before they are widely available, 

and help others by contributing to medical research. 

For information about current studies, visit 

www.ClinicalTrials.gov. 

For More Information 

American Society of Pediatric Nephrology 

3400 Research Forest Drive, Suite B7 

The Woodlands, TX 77381 

Phone: 281–419–0052 

Fax: 281–419–0082 

Email: info@aspneph.com 

Internet: www.aspneph.com 

National Kidney Foundation 

30 East 33rd Street 

New York, NY 10016 

Phone: 1–800–622–9010 or 212–889–2210 

Fax: 212–689–9261 

Internet: www.kidney.org 

Acknowledgments 

Publications produced by the Clearinghouse are 

carefully reviewed by both NIDDK scientists and 

outside experts. This publication was originally 

reviewed by the American Society of Pediatric 

Nephrology’s (ASPN) Clinical Affairs Committee: 

Barbara Fivush, M.D.; Kathy Jabs, M.D.; Tej 

Mattoo, M.D.; William Primack, M.D.; Joseph 

Flynn, M.D.; Ira Davis, M.D.; Ann Guillott, M.D.; 

Steve Alexander, M.D.; Deborah Kees-Folts, M.D.; 

Alicia Neu, M.D.; Steve Wassner, M.D.; John 

Brandt, M.D.; and Manju Chandra, M.D. Frederick 

Kaskel, M.D., Ph.D., president, ASPN, and Sharon 

Andreoli, M.D., secretary-treasurer, ASPN, also 

provided comments and coordination. 

You may also find additional information about this topic by 

•	 searching the NIDDK Reference Collection at 

www.catalog.niddk.nih.gov/resources

•	 visiting MedlinePlus at www.medlineplus.gov

This publication may contain information about medications. 


When prepared, this publication included the most current
 

information available. For updates or for questions about any
 

medications, contact the U.S. Food and Drug Administration
 

toll-free at 1–888–INFO–FDA (463–6332) or visit www.fda.gov. 


Consult your doctor for more information.
 

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National Kidney and Urologic 

Diseases Information Clearinghouse 

3 Information Way 

Bethesda, MD 20892–3580 

Phone: 1–800–891–5390 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: nkudic@info.niddk.nih.gov 

Internet: www.kidney.niddk.nih.gov 

The National Kidney and Urologic Diseases 

Information Clearinghouse (NKUDIC) is a 

service of the National Institute of Diabetes 

and Digestive and Kidney Diseases (NIDDK). 

The NIDDK is part of the National Institutes 

of Health of the U.S. Department of Health 

and Human Services. Established in 1987, 

the Clearinghouse provides information 

about diseases of the kidneys and urologic 

system to people with kidney and urologic 

disorders and to their families, health care 

professionals, and the public. The NKUDIC 

answers inquiries, develops and distributes 

publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about 

kidney and urologic diseases. 

This publication is not copyrighted. The Clearinghouse encourages users of this fact sheet to duplicate 

and distribute as many copies as desired. 

This fact sheet is also available at 

www.kidney.niddk.nih.gov. 

U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

NIH Publication No. 09–4570 

January 2009