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Anuric acute renal failure caused by dextran 40 administration
R Ferraboli1, P S Malheiro, R C Abdulkader
1Department of Medicine, Hospital das Clínicas, University of São Paulo Medical School, Brazil.
Renal Failure
|March 1, 1997
Summary
Dextran 40, a plasma substitute, can rarely cause acute renal failure. Plasma-pheresis effectively restored kidney function in two patients experiencing this adverse reaction.
Area of Science:
- Nephrology
- Pharmacology
- Internal Medicine
Background:
- Dextran 40 is widely utilized in clinical settings as a plasma volume expander.
- Its known benefits include improved microcirculation and antithrombogenic effects.
- However, acute renal failure is an uncommon adverse effect of dextran administration.
Observation:
- An uncommon adverse effect of dextran administration is oligoanuric acute renal failure.
- Two cases of anuric acute renal failure (ARF) specifically induced by dextran 40 are presented.
Findings:
- Both patients experienced rapid resumption of diuresis and renal function following plasma-pheresis.
- Renal biopsies showed normal kidney structures, with tubular swelling and vacuolation indicating osmotic nephrosis.
Implications:
- This highlights a rare but serious renal adverse effect of dextran 40.
- Plasma-pheresis emerges as a potentially effective treatment for dextran-induced acute renal failure.
- Understanding osmotic nephrosis is crucial for managing adverse reactions to plasma substitutes.