Related Experiment Video
Updated: Feb 6, 2026
06:26
Mouse Model of Metabolic Dysfunction-Associated Steatotic Liver Disease with Fibrosis
Published on: July 18, 2025
883
Hypertriglyceridemia Causing Continuous Renal Replacement Therapy Dysfunction in a Patient with End-stage Liver
D C McLaughlin1, D C Fang2, B A Nolot3
1Department of Critical Care, Mayo Clinic, Florida, USA.
Indian Journal of Nephrology
|August 31, 2018
Summary
Severe hypertriglyceridemia can impede continuous renal replacement therapy (CRRT) in critically ill patients. Prompt intervention, like therapeutic plasma exchange, is crucial for managing filter clotting and life-threatening complications.
Area of Science:
- Nephrology
- Critical Care Medicine
- Hepatology
Background:
- Continuous renal replacement therapy (CRRT) is vital for critically ill patients with kidney injury.
- Hypertriglyceridemia is an uncommon but serious complication that can disrupt CRRT.
- Liver transplant recipients are susceptible to metabolic derangements.
Observation:
- A critically ill liver transplant patient experienced recurrent filter clotting during CRRT.
- Elevated serum triglycerides (TGs) led to lipemic blood, rendering the dialytic circuit nonfunctional.
- This nonfunctionality posed immediate risks of hyperkalemia and metabolic acidosis.
Findings:
- Persistent hypertriglyceridemia, attributed to medication side effects and liver graft failure, caused CRRT circuit failure.
- Emergent therapeutic plasma exchange successfully lowered TG levels, enabling resumption of CRRT.
- The patient's hypertriglyceridemia and liver dysfunction resolved after a second liver transplant.
Implications:
- Highlights the critical need to monitor triglyceride levels in critically ill patients undergoing CRRT.
- Underscores the potential for severe hypertriglyceridemia to cause CRRT malfunction.
- Demonstrates the efficacy of therapeutic plasma exchange in managing this complication and the importance of addressing underlying causes like liver failure.
More Related Videos
Related Concept Videos
01:30Continuous Renal Replacement Therapy
1.1K
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
1.1K
01:26Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
224
Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in...
224
01:26Diseases of the Liver and Gallbladder
2.0K
Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
2.0K
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
202
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
202
00:59Gene Therapy
27.6K
Gene therapy is a technique where a gene is inserted into a person’s cells to prevent or treat a serious disease. The added gene may be a healthy version of the gene that is mutated in the patient, or it could be a different gene that inactivates or compensates for the patient’s disease-causing gene. For example, in patients with severe combined immunodeficiency (SCID) due to a mutation in the gene for the enzyme adenosine deaminase, a functioning version of the gene can be...
27.6K
01:25Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance
227
In healthy individuals, serum creatinine levels remain stable due to a balance between its constant production—primarily from muscle metabolism—and renal excretion. Creatinine is freely filtered by the glomeruli, making it a valuable marker for estimating renal function. When the glomerular filtration rate (GFR) decreases, the kidneys can only eliminate less creatinine, causing serum levels to rise.Serum creatinine concentration is widely used to estimate creatinine clearance...
227