What is the first-line treatment for hemolytic uremic syndrome?

In cases of hemolytic uremic syndrome (HUS), especially when it occurs following an infection with certain strains of E. coli (like E. coli O157:H7), the primary focus of treatment is supportive care. This includes ensuring adequate hydration and maintaining blood pressure, which is where intravenous (IV) fluids come into play.

Administering IV fluids helps to prevent dehydration and supports renal function by ensuring that the kidneys are adequately perfused. Maintaining fluid balance can also help mitigate complications associated with acute kidney injury, which is a hallmark of HUS.

While some of the other options might be considered in certain contexts, they do not address the immediate need for hydration and stabilization of the patient as effectively as IV fluids do. For instance, antibiotics are generally not recommended because they can increase the risk of complications in the context of HUS, and corticosteroids have not been consistently shown to be effective in this condition. Dialysis may become necessary if renal function severely declines, but it is typically not the first-line treatment. Thus, providing IV fluids stands out as the most immediate and critical intervention in managing HUS.