Early IV reduces renal risk after E. coli

ST. LOUIS, July 23 (UPI) -- Intravenous fluids given the first four days of diarrhea onset may reduce the risk of renal failure among children infected with E. coli, U.S. researchers say.

Dr. Christina A. Hickey of Washington University School of Medicine and St. Louis Children's Hospital and colleagues says the study involved 11 pediatric hospitals in the United States and Scotland.

The researchers identified 50 patients, age 17 and younger, who had a post-diarrheal illness that met the case definition of hemolytic uremic syndrome -- occurs when an infection in the digestive system produces toxic substances that destroy red blood cells causing kidney damage -- which usually occurs after diarrhea caused by Shiga toxin-producing bacteria, particularly E. coli O157:H7.

"In summary, intravenous volume expansion early in illness was associated with better renal outcome during hemolytic uremic syndrome," the study authors say in a statement.

"Intravenous volume expansion is an underused intervention that could decrease the frequency of oligoanuric renal failure -- decreased kidney function, with a urine output of less than 0.5 milliliters per kilogram of body weight per hour, for at least one day -- in patients at risk of hemolytic uremic syndrome -- destruction of red blood cells."

There have been more than 900 cases of hemolytic uremic syndrome in 16 countries in Europe and North America since an E. coli outbreak began in Germany last May.

The article, published on Online First by Archives of Pediatrics and Adolescent Medicine, is being released early because of its important public health implications.