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transfusion is only indicated in patients with active bleeding or when an
invasive procedure is intended.
Up to 50% of children with typical HUS will require RRT. Dialysis is
also indicated to safely provide blood products and nutritional support in
the setting of persistent oligoanuria. The modality of dialysis depends on
the expertise of the center. However, if there are severe abdominal
complications requiring surgical intervention, hemodialysis will be
necessary as peritoneal dialysis will be contraindicated.

Postinfectious Glomerulonephritis
Goals of Treatment
The goals of treatment for postinfectious glomerulonephritis are supportive
in nature. The consequences of fluid retention such as pulmonary edema
and hypertension should be managed, as necessary. AKI and its
complications may necessitate medical intervention such as RRT in severe
cases. Children with evidence of active underlying infections should be
treated appropriately.
CLINICAL PEARLS AND PITFALLS
Clinical presentation of nephritis includes hematuria, edema, and
hypertension.
Postinfectious glomerulonephritis most often occurs after an
infection with group A streptococci.
Care is supportive, including management of fluid balance and
blood pressure, and most children recover fully.
Clinical Considerations
Clinical recognition. Postinfectious glomerulonephritis is the leading cause
of glomerulonephritis in children worldwide and has been associated with a
multitude of bacteria, viruses, and parasites. Historically, nephritogenic
strains of group A β-hemolytic streptococci have been the most frequently
implicated organisms, often after a proceeding pharyngitis or cellulitis.
However, in recent years nonstreptococcal organisms have emerged as the

leading cause of postinfectious glomerulonephritis in high-income