Early high-volume IV fluids to protect children's kidneys after E. coli infection

Hyperhydration to Improve Kidney Outcomes in Children with Shiga Toxin-Producing E. Coli Infection (HIKO STEC): A Multinational, Embedded, Cluster, Crossover, Randomized Trial

NIH-funded research University of Calgary · NIH-11171689

Giving extra IV fluids early to children with Shiga toxin–producing E. coli infection to help prevent kidney damage.

Quick facts

Grant typeR01 grant
Study typeNIH-funded research
Funding institutionUniversity of Calgary NIH-funded
Lab location1 site (Calgary, Canada)
Project IDNIH-11171689 on NIH RePORTER

What this research studies

If a child with suspected Shiga toxin–producing E. coli infection comes to a participating hospital, care teams in different hospitals and time periods will follow either an early aggressive IV fluid plan or the usual conservative fluid approach. Hospitals are randomized in a cluster, crossover design so sites switch between approaches over time, and children are treated according to the assigned approach when they present. Investigators will track whether early volume expansion lowers the chance of developing hemolytic uremic syndrome, needing dialysis, or having other serious complications, and will follow kidney health over time. The trial is multinational and embedded in routine emergency and hospital care so eligible children are enrolled when they present to participating centers.

Who could benefit from this research

Good fit: Children (infants through about 11 years) who present to a participating emergency department or hospital with suspected or confirmed Shiga toxin–producing E. coli infection early in their illness.

Not a fit: Children without STEC infection, those already in advanced HUS with established severe kidney failure, or those with medical reasons that make extra fluids unsafe (for example, heart failure) are unlikely to benefit from this approach.

Why it matters

Potential benefit: If successful, the approach could lower the risk of severe kidney injury, reduce the need for dialysis, and decrease long-term kidney problems in affected children.

How similar studies have performed: Only a few small randomized trials from decades ago showed no clear benefit, while recent observational studies suggest early hyperhydration might help but remain unproven in a large randomized trial.

Where this research is happening

Calgary, Canada

Researchers

About this research

  1. This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
  2. Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
  3. For full project details, budget, and progress reports, visit the official NIH RePORTER page below.
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.