Complication of oliguric acute renal failure in patients treated with low-molecular weight dextran.

Abstract

Acute renal failure (ARF) is a well-documented but infrequent complication in patients treated with low-molecular weight dextran (LMWD). We herein report 3 cases of oliguric ARF following the administration of dextran-40. One case developed ARF totally after 1.200 g of LMWD administration. In contrast, two cases having increased serum creatinine developed oliguria despite the acceptable therapeutic doses (totally 450 and 650 g). Contrast media was also co-administered in these patients. Plasma exchange (PE), double filtration plasmapheresis (DFPP), or continuous hemodiafiltration (CHDF) but not hemodialysis (HD) reduced circulating dextran concentrations by 35-44% during a single session. All patients completely recovered from ARF by 14-32 days after the treatment. Our cases suggested that radiocontrast could predispose to the development of LMWD-induced ARF especially in patients having pre-existing renal dysfunction. In addition, PE, DFPP and CHDF afforded a beneficial effect for removing accumulated LMWD from the circulation.

• Authors: A Kato, K Yonemura, H Matsushima, N Ikegaya, A Hishida
• Journal: Renal failure (Ren Fail) Vol. 23 Issue 5 Pg. 679-84 (Sep 2001) ISSN: 0886-022X [Print] England
• PMID: 11725914 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anticoagulants
• Dextrans

Topics

• Acute Kidney Injury (chemically induced, complications, diagnosis)
• Aged
• Anticoagulants (adverse effects, therapeutic use)
• Cerebral Infarction (drug therapy)
• Dextrans (adverse effects, therapeutic use)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Female
• Hearing Loss, Sudden (drug therapy)
• Humans
• Kidney Function Tests
• Male
• Middle Aged
• Oliguria (chemically induced, complications, diagnosis)
• Prognosis
• Risk Assessment
• Severity of Illness Index