Expert Opinion | What you need to know about the dangers posed by E. coli to the kidneys

With the holiday season underway, and grocery shopping and cooking on everyone’s minds, stories about E. coli in the news can seem extra scary. Earlier this fall, there was an outbreak involving fast food; more recently, another led to recalls of baby carrots and other produce.

As a nephrologist, my medical specialty involves treating kidney diseases. And as someone who also enjoys the occasional stop for fast food, I understand the concern is real. From fast food to the produce aisle, where else could E. coli be lurking?

Here’s what you need to know about the dangers posed by E. coli to my favorite organ, the kidneys. Your kidneys won’t fail if you consume a hamburger, but they might if you contract uncontrolled diarrhea and can’t keep enough fluids down to keep your body hydrated. The good news is you can be proactive about guarding against the potential for E. coli to lead to a dangerous and sometimes deadly condition, hemolytic uremic syndrome.

» READ MORE: E. coli: What you need to know

Hemolytic uremic syndrome (HUS) is a rare complication of the E. coli strain O157:H7. It can cause vomiting, diarrhea, and occasionally fever.

This E. coli strain produces Shiga toxin, which can damage the blood vessels. It frequently causes frightening bloody diarrhea, rather than your typical loose stools.

HUS is most commonly seen in children under 10 years of age who are infected, whether through person-to-person contact at a daycare or animal exposure at a farm. In recent years, outbreaks in prepared and fast food products have led to an increased incidence in HUS in adults.

How do we prevent HUS from happening, beyond avoiding recalled foods? The best thing to do is remain vigilant of symptoms. Shiga toxin E. coli or STEC infections affect about 2.8 million people a year, and about 15 to 20% develop HUS.

Infections follow a predictable timeline: Initial symptoms develop about 3 days after exposure to the bacteria. Vomiting and fevers can occur for the next 1 to 3 days, and most people recover from the infection within 5 to 13 days.

If you have these symptoms and they aren’t going away or seem to be getting worse, or you cannot keep enough fluids down to remain hydrated, you should go to the hospital.

Whenever you have diarrhea, it’s critical to stay hydrated. The choice of fluids doesn’t matter.

If you have symptoms suggestive of HUS, the toxins can actually shut the kidneys down. This is due to the type and degree of inflammation occurring, and can happen regardless of how much you are drinking. This requires hospital monitoring to watch for changes in your kidney function that indicate you might need dialysis.

You don’t need to proactively change too much in your daily life; just be aware.

This begs the bigger question of food safety: How can we trust our food is safe to consume? E. coli can make its way into our food from several different sources. Animal waste products are a particular concern, and contaminated water sources have been a significant problem in produce. For meat, issues with the processing of products can lead to fecal contamination.

The average consumer can do little more than watch recall announcements and remain vigilant for signs of serious infection. We can also start educating ourselves about how we consume food in America and advocating for safe production practices for our mass-produced meats and vegetables.

Helena Kurniawan is a nephrologist who currently works at Cooper University Hospital in Camden.