Prognostic significance of microalbuminuria in postdiarrheal hemolytic uremic syndrome

Patients who survive the acute phase of postdiarrheal hemolytic uremic syndrome (D+ HUS) may develop renal complications after years of apparent recovery. The optimal regimen for monitoring these children is unclear. We therefore determined if screening for microalbuminuria, in the absence of overt proteinuria at follow-up, increased the sensitivity for predicting long-term renal-related sequelae. We found that screening for microalbuminurea, within the first 6–18 months following an episode of HUS, increased the sensitivity for predicting later sequelae from 22 to 66.7%, compared to screening for overt proteinuria alone. These findings, if confirmed by a larger cohort with more years of follow-up, may facilitate early initiation of intervention strategies designed to reduce progressive renal damage.