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Case Report: Efficacy of albumin dialysis for the reversal of bile cast nephropathy-induced acute kidney injury

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Last modified
  • 06/17/2025
Type of Material
Authors
    Aaron G. Issac, Emory UniversityMichael A. Yu, Emory UniversityDesiree M. Rogers, Emory UniversityRam Subramanian, Emory University
Language
  • English
Date
  • 2023-10-10
Publisher
  • Frontiers
Publication Version
Copyright Statement
  • © 2023 Issac, Yu, Rogers and Subramanian
License
Final Published Version (URL)
Title of Journal or Parent Work
Volume
  • 3
Start Page
  • 1256672
Grant/Funding Information
  • The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
Abstract
  • Background Bile cast nephropathy (BCN) is an underdiagnosed renal complication associated with severe hyperbilirubinemia and is seen in patients with liver failure who have cholestatic complications. BCN-induced acute kidney injury (AKI) can require hemodialysis (HD), and the molecular adsorbent recirculating system (MARS) is a potentially useful therapeutic option. Case summary A 57-year-old male presented with jaundice persisting for 1 month, with laboratory test results indicative of hyperbilirubinemia and AKI. Abdominal imaging and a biopsy confirmed biliary ductal dilation secondary to a pancreatic head mass. The patient had rapidly progressive renal failure and refractory hyperbilirubinemia, despite biliary decompression, and was started on HD. Subsequent therapy with albumin dialysis therapy using MARS was successful in reversing the AKI, the cessation of HD, and the restoration of native renal function. Conclusion In the setting of BCN-induced AKI, timely initiation of MARS can provide a useful therapeutic strategy to reverse renal dysfunction and facilitate intrinsic renal recovery.
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Research Categories
  • Health Sciences, Medicine and Surgery

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