Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about hemolytic uremic syndrome. And if you want to follow along with written notes on

this topic, you can follow along at zero tofinals.com slash hus or in the renal section of the zero definals medicine book. So let's get

straight into it. Hemalytic uremic syndrome also known as hus occurs when there's thrombosis in the small

blood vessels throughout the body. Remember thrombosis is blood clots. So this is where

little blood cuts occur within the small blood vessels throughout the body. This is

usually triggered by a bacterial toxin called the sugar toxin. And it leads to a classic

triad of hemalytic anemia.

So this is anemia caused by the breakdown of red blood cells.

Acute kidney injury and a low platelet count, which is described as thrombocytopenia.

The most common cause is a toxin produced by the bacteria E. coli. 0157, which is called the Shigga toxin.

A different bug called Shigella also produces this same toxin, and the use of antibiotics and antimotility medications like laparamide to treat gastroenteritis caused by these particular pathogens

increases the risk of developing hemolitic uremic syndrome. So this is the main reason when

somebody has gastroenteritis that we wouldn't routinely use antibiotics or leperamide to treat the condition.

So how does it present?

Well E. coli 0157 causes a brief gastroenteritis, often with bloody diarrhea,

and about five days after the diarrhea, the person will start displaying symptoms of

hemolytic uremic syndrome. And these are things like reduced urine output because of the acute kidney injury,

hematuria or dark brown urine, abdominal pain, lethargy and irritability,

confusion, hypertension or high blood pressure, and also bruising.

So how do we manage the condition? Well, hemolytic uremic syndrome is a medical emergency and it's got a very high mortality rate of about 10%.

The condition is self-limiting, so treatment is with supportive management. And this is with

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