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PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly publication, it has beenpublished continuously since 1948. PEDIATRICS is owned, published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, Illinois, 60007. Copyright ©2005 by the American Academy of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.
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Relative NephroprotectionDuring Escherichia coli O157:H7 Infections: Association With Intravenous Volume Expansion
Julie A. Ake, MD*‡; Srdjan Jelacic, BS§; Marcia A. Ciol, PhD‡; Sandra L. Watkins, MD‡§; Karen F. Murray,MD‡§; Dennis L. Christie, MD‡§; Eileen J. Klein, MD, MPH‡§; and Phillip I. Tarr, MD‡§
ABSTRACT. Objective. The hemolytic uremic syndrome (HUS) consists of hemolytic anemia, thrombocytopenia, and renalfailure. HUS is often precipitated by gastrointestinal infection with Shiga toxin–producing Escherichia coli and is characterized by a variety of prothrombotic host abnormalities. In much of the world, Ecoli O157:H7 is the major cause of HUS. HUS can be categorized as either oligoanuric (which probably signifies acute tubular necrosis) or nonoligoanuric. Children with oligoanuric renal failure duringHUS generally require dialysis, have more complicated courses, and are probably at increased risk for chronic sequelae than are children who experience nonoligoanuric HUS. Oligoanuric HUS should...