Hemolytic uremic syndrome in adults

The long-term clinical course of 11 adults with hemolytic-uremic syndrome (HUS) is reported. All patients were treated with heparin and antiplatelet drugs, and 10 required dialysis. One patient died after 38 days; the others recovered from anuria after 7-400 days. One patient was resubmitted to regular dialysis 5 yr later, and another died because of cerebral hemorrhage. Among the remaining 8 patients, 4 show renal failure and 4 have normal renal function after 1-10 yr of observation. All but 3 require vigorous antihypertensive therapy. It is concluded that in adults with HUS (1) recovery may occur even after a prolonged anuria; (2) severe hypertension and progressive renal failure may appear later in apparently recovered patients; and (3) heparin and antiplatelet drugs seem to be beneficial in reversing acute renal failure.