ArticlePediatric nephrology (Berlin, Germany)2024
Volume expansion mitigates Shiga toxin-producing E. coli-hemolytic uremic syndrome in children.
Article in Pediatric nephrology (Berlin, Germany), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 6 citations in OpenAlex.
- Impact of early volume expansion on severe long-term kidney sequelae in children with Shiga toxin-producing Escherichia coli hemolytic uremic syndrome.Pediatric nephrology (Berlin, Germany) · 2026Observational
- Acute neurologic clinical manifestations and outcomes in children with thrombotic microangiopathies in paediatric intensive care units.European journal of pediatrics · 2026Observational
- Bloody diarrhea, STEC infection, and HUS in the molecular microbiology era.Pediatric nephrology (Berlin, Germany) · 2026Review
- Shiga Toxin-Producing Escherichia coli Outbreak in Canadian Daycare Centers.JAMA network open · 2026Article
- Long-term outcomes of volume expansion treatment in diarrhea-associated hemolytic uremic syndrome: a six-year follow-up.Pediatric nephrology (Berlin, Germany) · 2026Article
- EnterohemorrhagicFrontiers in cellular and infection microbiology · 2025Article
- The impact of climate variation on the spread of Shiga toxin-producing E. coli.Pediatric nephrology (Berlin, Germany) · 2025Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundShiga toxin-producing E. coli-hemolytic uremic syndrome (STEC-HUS) is associated with high morbidity and relevant mortality. Previous small studies showed that volume expansion could improve the course and outcome of STEC-HUS. The aim of this single-center study was to evaluate the effect of volume expansion on the clinical course and outcome in STEC-HUS.
methodsData of pediatric patients with STEC-HUS were analyzed retrospectively. Course and outcome of patients treated with volume expansion (VE) from 2019 to 2022 (n = 38) were compared to historical controls (HC) from 2009 to 2018 (n = 111).
resultsPatients in the VE group had a significant relative median weight gain compared to HC (7.8% (3.4-11.3) vs. 1.2% (- 0.7-3.9), p < 0.0001) 48 h after admission. The need for dialysis was not reduced by VE (VE 21/38 (55.3%) vs. HC 64/111 (57.7%), p = 0.8). However, central nervous system involvement (impairment of consciousness, seizures, focal neurological deficits, and/or visual disturbances) was significantly reduced (VE 6/38 (15.8%) vs. HC 38/111 (34.2%), p = 0.039). None of the patients in the VE group died or developed chronic kidney disease (CKD) stage 5, whereas in the HC group, three patients died and three patients had CKD stage 5 at discharge.
conclusionsThis study suggests that volume expansion may be associated with the mitigation of the acute course of STEC-HUS, especially severe neurological involvement and the development of CKD. Prospective trials should lead to standardized protocols for volume expansion in children with STEC-HUS.
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