A case of 5—year—old boy with D+HUS who developed oliguira but could avoid dialysis therapy

概要

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Diarrhea—associated hemolytic syndrome (D+HUS) is the disease that causes acute severe renal failure and often requires dialysis therapy. However, in many cases, renal function can be recovered. Oliguria is an absolute indication of dialysis therapy in the guideline of Japanese Society of Pediatric Nephrology for D+HUS. We report a case of D+HUS with oliguria who could avoid dialysis therapy. The case is a 5—year—old boy with fever, hematochezia and diarrhea. He went to see a regional hospital and pointed out the renal dysfunction and thrombocytopenia. He also developed oliguria and referred to our hospital. On the day of admission, He developed anuria without showing any electrolyte abnormalities and symptoms suggesting overhydration, so we did not perform dialysis therapy. On the fifth hospital day, urinary output started to increase and the patient was managed without dialysis therapy until discharge. If restrict monitoring and immediate performing of dialysis therapy can be done, it may be possible to treat the patient with oliguria without performing dialysis therapy.