Hot topics in Nephrology

Topic Atypical Haemolytic Uraemic Syndrome

A 52 year old man was transferred to the renal unit with a four day history of fatigue, shortness of breath, headache and malaise.

On examination, he was pale with multiple petechiae on his arms and legs. Blood pressure was 175/90.


Haemoglobin 84g/L (130-180)
Platelet count 3x109/L (150-400)
Prothrombin time 13s (11.5-15.5)
International normalised ratio 1.1 (<1.4)
Serum creatinine 1100 µmol/L (60-110)
Serum lactate dehydrogenase 891U/L (10-250)

Blood film showed schistocytes

Which is the next most appropriate test to guide management?