Evaluation of Hypertension in Pediatric Hemolytic Uremic Syndrome (A Cross‐Sectional Study)

TL;DR

This study finds that nearly half of children with HUS have high blood pressure, which is linked to heart issues and low potassium levels.

Contribution

The study is one of the few to evaluate hypertension prevalence and its clinical correlates in pediatric HUS patients.

Findings

Hypertension was observed in 48% of children diagnosed with HUS.

HTN was significantly associated with hypokalemia and cardiac involvement.

Routine blood pressure monitoring is recommended for pediatric HUS patients due to cardiovascular risks.

Abstract

Hemolytic uremic syndrome (HUS), particularly the Shiga toxin‐producing Escherichia coli (STEC)‐associated subtype, is a major cause of acute kidney injury [AKI] in children. Although hypertension (HTN) is a recognized complication of HUS, its prevalence and related risk factors in these children are particularly poorly studied.

This study is designed to determine the prevalence of HTN among children diagnosed with HUS and to identify its potential clinical correlates, including laboratory parameters and cardiac involvement.

A descriptive cross‐sectional study was conducted on 50 pediatric patients diagnosed with HUS and hospitalized in our tertiary nephrology ward between 2021 and 2024. Clinical and laboratory data, including blood pressure, BMI, renal function markers, and echocardiographic findings, were extracted from medical records. HTN was defined using the AAP Pediatric HTN calculator. Statistical analysis was performed using SPSS v26 software, t‐tests, chi‐square, and Fisher's exact test.

HTN was observed in 48% of our patients. No significant associations were found between HTN and age, sex, BMI, HUS type, urea, creatinine, or hemoglobin levels. However, HTN was significantly associated with hypokalemia (p = 0.011) and cardiac involvement (p = 0.045). Among patients with AKI, 54.2% had HTN; however, this association was not significant (p = 0.402).

Although this study is a small one and was done in a single center, it supports the importance of HTN in patients with HUS. HTN is quite prevalent among children with HUS and shows a significant association with cardiac complications and electrolyte imbalances. These findings indicate the importance of routine blood pressure monitoring and cardiovascular assessment in the management of pediatric HUS. Lifelong follow‐up is recommended for early detection of signs of chronic kidney and cardiovascular sequelae.