[Hemolytic-uremic syndrome in children and arterial hypertension].

Seventy patients (55 infants and 15 children) with the hemolytic uremic syndrome (HUS) were reviewed to evaluate the incidence of hypertension in HUS. Refractory hypertension was only observed in 5 infants (3 at onset and 2 after several months), whereas it was present in 9 children (4 at onset and 5 in the course of the disease). Controllable hypertension was present in 10 patients (8 infants and 2 children). Histopathological examination of renal specimens in 52 patients showed 3 patterns: cortical necrosis in 10, Thrombotic microangiopathy (TMA) with predominant glomerular involvement in 29 and TMA with predominant arterial involvement in 13. Clinicopathologic correlations showed that severe hypertension was almost exclusively observed in the patients with "vascular TMA". Bilateral nephrectomy performed in 8 patients led to the rapid disappearance of hypertension, thus demonstrating the role of hyperreninaemia in the development of hypertension in the HUS.