IV fluids prevent renal failure in E Coli infections

Giving children intravenous (IV) fluids early in the course of Escherichia coli infection appears to lower the odds of developing severe renal failure.

Researchers at Washington University School of Medicine in St Louis, Missouri, studied 50 children younger than 18 years from 11 pediatric hospitals in the United States and Scotland who were treated for diarrhea-associated hemolytic uremic syndrome (HUS). According to the researchers, 90% of the cases of diarrhea-associated HUS in North America occur in children younger than 18 years.

Of the 25 patients who received any IV fluids during the first 4 days of illness, 52% developed oligoanuric HUS compared with 84% who received no IV fluids. The risk of oligoanuria was 60% higher if no IV fluids were given during the first 4 pre-HUS days.

Clinical profiling can identify patients who might be infected with E coli and at risk of developing HUS, allowing for early use of IV volume expansion. Renal recovery cannot be hastened once oligoanuria is established, the researchers add.

Hickey CA, Beattie TJ, Cowieson J, et al. Early volume expansion during diarrhea and relative nephroprotection during subsequent hemolytic uremic syndrome. Arch Pediatr Adolesc Med. 2011. Epub ahead of print.