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Efficacy of extracorporeal albumin dialysis for acute kidney injury due to
cholestatic jaundice nephrotoxicity
#MMPMID27389722
Sens F
; Bacchetta J
; Rabeyrin M
; Juillard L
BMJ Case Rep
2016[Jul]; 2016
(?): ? PMID27389722
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We report a case of a 37-year-old man with Maturity Onset Diabetes of the Youth
(MODY) type 5, admitted for an episode of cholestasis and a simultaneous acute
kidney injury (AKI). Chronic liver disease was due to a mutation in the
transcription factor 2 (TCF2) gene, thus highlighting the need for a close liver
follow-up in these patients. AKI was attributed to a cholemic nephropathy based
on the following rationale: (1) alternative diagnoses were actively ruled out;
(2) the onset of AKI coincided with the onset of severe hyperbilirubinaemia; (3)
renal pathology showed large bile tubular casts and a marked tubular necrosis and
(4) creatinine serum dramatically decreased when bilirubin levels improved after
the first sessions of extracorporeal albumin dialysis (ECAD), thus suggesting its
role in renal recovery. Even though cholestasis can precipitate renal injury, the
diagnosis of cholemic nephropathy could require a renal biopsy at times. Future
studies should confirm the benefits of ECAD in cholemic nephropathy.
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