Renal failure associated with the use of dextran-40

A typical case of dextran-40 associated acute renal failure is presented. In this patient a single plasma exchange was successful in considerably lowering the plasma dextran concentration. At the same time the elevated plasma oncotic pressure was reduced to normal values. Diuresis returned within 12 h. Several possible explanations of the mechanism of renal failure associated with the use of dextran-40 are discussed. While the mechanism of dextran-associated renal failure remains unsolved, plasma exchange seems to be effective therapy.