[Pathomorphology of the kidneys in hemolytic-uremic syndrome in children]

The kidneys were studied morphologically in 64 cases of hemolytic-uremic syndrome (HUS) in children aged from 17 days to 4 years. Three variants of the kidney alterations are distinguished depending on the duration of acute renal failure (ARF): early, late and delayed alterations. Early alterations were observed if ARF lasted for 1-10 days and were characterized by glomerular thrombotic microangiopathy with disturbance of the nephron proximal part function resultant from microcirculatory damage. Late kidney alterations (11-20 days of ARF) consisted of glomerular thrombi fibrinolysis, development of mesangial cell proliferation and mesangiolysis, proximal tubular epithelium regeneration and the appearance of nephrohydrosis resulting from the distal nephron part obstruction by hyalin cylinders. Delayed alterations (21-62 days of ARF) manifested with predominant atrophic and sclerotic processes. The first variant corresponded to the acute course of HUS while the two last variants to the subacute one.