Oakes et al identified risk factors for mortality of a pediatric patient with postdiarrheal hemolytic uremic syndrome (HUS). These can help identify a patient who may benefit from more aggressive management, preferably at a tertiary pediatric hospital. The authors are from the University of Utah.


Patient selection:

(1) age < 18 years of age

(2) postdiarrheal hemolytic uremic syndrome


Causes of death:

(1) cerebral involvement (stroke, cerebral edema, etc.)

(2) congestive heart failure

(3) intra-alveolar hemorrhage or respiratory arrest

(4) hyperkalemia


Risk factors on admission associated with mortality:

(1) dehydration (relative risk 1.9)

(2) oliguria or anuria (relative risk 1.8 and 2.6 respectively)

(3) seizures (relative risk 8.5)

(4) white blood cell count > 20,000 per µL (relative risk 2.6)

(5) hematocrit > 23% (relative risk 7.6)



• An hematocrit > 23% does not seem high, especially in a patient who is dehydrated.


To read more or access our algorithms and calculators, please log in or register.