The importance of nonrenal involvement in hemolytic-uremic syndrome.

Fifteen children with the clinical manifestations of hemolytic-uremic syndrome are reported. Prompt recognition of the syndrome and effective therapy for acute renal failure including early dialysis were instituted in each case. Analysis of the clinical course and histopathologic features in these patients indicated that early dialysis and effective management of acute renal failure may unmask evidence of nonrenal involvement; microthrombi may be found in a wide distribution of organs, including the brain and myocardium; and extent and severity of nonrenal involvement become an important determinant of ultimate prognosis.