[Iatrogenic generalized storage of dextran in regularly dialyzed patients]

Intensive generalized intracellular storage of a PAS positive birefringent material with unusual ultrastructure was found in 17 patients deceased after long-term hemodialysis. It was identified as "condensed" dextran administered repeatedly for hypotension during dialysis. Intensity of storage was related to residual diuresis and not to the number of dialyses. Identification of the material was enabled by digestion with dextranase. Dextran cytoplasmic inclusions in macrophages resisted to common solvents but dissolved in lyes. The storage occurred in lymph-nodes, in the heart, kidney interstitium, bone marrow and others. Fatal complications of massive dextran storage were discussed. Quantity, morphogenesis and location of storage are learning about storing systems.