To explore the clinical features and therapeutic strategy for hemolytic uremic syndrome (HUS) associated with falciparum malaria.

The medical records of 13 patients with HUS who were admitted to Beijing Ditan Hospital, Capital Medical University from 2008 to 2014 were reviewed, retrospectively. The clinical features, auxiliary examination results and therapeutic strategy were assessed, respectively.

Among the 13 cases, 12 cases were male and 1 was female; ages of the 13 patients were ranged from 22 to 60 years old. Every patient conformed to the diagnosis of HUS associated with falciparum malaria. There were 10 patients developed cerebral malaria, one case was secondary to gastrointestinal bleeding and 2 patients had respiratory and circulatory failure. After treatments of anti-malaria, hormone therapy, ventilator-assisted and continuous venovenous hemodiafiltration (CVVHDF), etc, one patient died, one patient was discharged by his own accord, and 11 patients were cured with no chronic renal damage. Five patients with acute renal failure were recovered by CVVHDF. During the follow up visiting, two of them recrudesced.

Early diagnosis and treatment of malaria play important roles in hemolysis and organ damage. High-dose, long period of treatment with the artemether can strengthen resistance to malaria. Early application of hormone could prevent hemolysis and alleviate kidney damage effectively. In order to reduce mortality, patients who have severe hemolysis or acute renal failure should be treated with hemodiafiltration therapy in time.