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.

Effects of Aspirin and Low-Dose Heparin in Head and Neck Reconstruction using Microvascular Free Flaps

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“…Case reports have described more than 60 patients developing ARF attributable to dextran 40 administration [70][71][72]74,76,79,83,84,87,[90][91][92]95]. ARF associated with dextran 40 infusion was encountered in 4.7% out of 211 acute ischaemic stroke patients [63].…”

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“…Several small studies have described oligo-anuric AKI with infusion of low molecular weight dextrans [29,[36][37][38]. HES has also been described to cause AKI, [14,39].…”