COMPLICATION OF OLIGURIC ACUTE RENAL FAILURE IN PATIENTS TREATED WITH LOW-MOLECULAR WEIGHT DEXTRAN

• Published in: Renal failure Vol. 23; no. 5; pp. 679 - 684
• Main Authors: Kato, Akihiko, Yonemura, Katsuhiko, Matsushima, Hideki, Ikegaya, Naoki, Hishida, Akira
• Format: Journal Article
• Language: English
• Published: Colchester Informa UK Ltd 01.01.2001; Taylor & Francis
• Subjects: Acute Kidney Injury - chemically induced; Acute Kidney Injury - complications; Acute Kidney Injury - diagnosis; Aged; Anticoagulants - adverse effects; Anticoagulants - therapeutic use; ARF; Biological and medical sciences; Cerebral Infarction - drug therapy; Continuous hemodiafiltration; Dextran; Dextrans - adverse effects; Dextrans - therapeutic use; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Hearing Loss, Sudden - drug therapy; Humans; Kidney Function Tests; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Oliguria; Oliguria - chemically induced; Oliguria - complications; Oliguria - diagnosis; Plasma exchange; Prognosis; Radiocontrast; Renal failure; Risk Assessment; Severity of Illness Index; Kidney disease; Human; Urinary system disease; Continuous; Acute; Plasmapheresis; Dextran; Case study; Extrarenal dialysis; Plasma exchange; Anuria; Hemodiafiltration; Treatment; Low; Renal failure; Complication; Molecular mass
• DOI: 10.1081/JDI-100107364
• ISSN: 0886-022X

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.