What if the Kidneys Don’t Recover after HUS?
Hemolytic uremic syndrome can cause severe kidney damage. What if the kidneys don’t recover after HUS?
Although kidney failure is usually temporary in HUS, some patients never regain sufficient kidney function. Others initially regain enough function to not only survive, but also seemingly thrive. The thriving does not last, though, because these patients go on to experience progressive renal failure within a few years.
A third category of HUS survivors regains normal kidney function, appearing to recover completely, except for having either microalbuminuria or overt proteinuria (if the hyperfiltration injury is more severe or advanced). Renal hyperfiltration injury slowly grinds away at the remaining nephrons until more than 90% have been destroyed (converted to scar tissue) at which point dialysis or kidney transplant is required. There is particular concern after 30 years of age, when renal obsolescence (as part of the normal ageing process) accelerates progressive hyperfiltration injury. Sufficient long-term experience to accurately predict the lifetime risk for end-stage renal disease (ESRD) is not available, but is at least 10% of HUS survivors.