Doctors discover therapy for lethal kidney disease in children caused by food poisoning

A drug therapy that protects children from potentially deadly kidney failure caused by food poisoning has been discovered by British doctors.

Eculizumab, which is already approved by the NHS to treat a rare genetic blood disorder, can also be used to spare sick youngsters from dialysis, transplants and even death, experts claim.

The most common cause of kidney failure in children is Shiga toxin-producing E. coli (STEC) – a bacterial infection picked up via contaminated food. Symptoms can range from mild cramps to bloody diarrhoea and vomiting.

In one in ten cases, STEC enters the bloodstream via the gut, which leads to damaged blood vessels forming clots in the kidney. This is known as haemolytic uremic syndrome (STEC-HUS).

The condition is particularly devastating in young children, with five percent of under ten-year-olds affected developing life-long kidney failure or dying.

Now analysis funded by the Medical Research Council and Kidney Research UK, and led by scientists from the University of Bristol, has uncovered how Shiga toxin damages the kidneys by attacking filtering cells inside the organs called podocytes. The team also found in lab animals that eculizumab halted this process.

The drug, sold as Soliris, is today used to treat paroxysmal nocturnal hemoglobinuria – a genetic condition in which the immune system damages red blood cells, which play a crucial role in kidney function

Richard Coward, professor of renal medicine at the University of Bristol, a consultant paediatric nephrologist at Bristol Royal Hospital for Sick Children and one of the study’s lead authors, says: ‘As a children’s kidney doctor, one of the most difficult and devastating diseases we treat is STEC-HUS, which causes kidney failure and death. We have now discovered that a cell in the kidney called the podocyte is a key target cell of Shiga toxin – and that it can be treated.’

Dr Aisling McMahon, executive director of research and policy at Kidney Research UK, adds: ‘This research shows STEC-HUS could be stopped in its tracks using a drug that is already in clinical use.’

The next steps for researchers to carry out will be to understand how quickly eculizumab needs to be given in STEC-HUC cases and perform trials in children at risk.