Abstract
Two children with prototypic hemolytic-uremic syndrome had prolonged acute dialysis-dependent renal failure (74 and 84 days) associated with a state of hyperproteinemia induced by extensive infusion of fresh frozen plasma (283 and 307 units). We believe that the hyperproteinemia prolonged the duration of renal failure. Following cessation of plasma therapy, the hyperproteinemic state reversed, the degree of proteinuria decreased and renal function quickly recovered. Although the pathophysiological mechanism requires further evaluation, we speculate that an alteration in the colloid oncotic pressure and/or aggravation of tubulointerstitial injury due to overload-proteinuria may have increased the duration of renal failure.
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References
Remuzzi G, Misiani R, Marchesi D, Livio M, Mecca G, De Gaetano G (1978) Haemolytic-uremic syndrome: deficiency of plasma factor(s) regulating prostacyclin activity? Lancet II: 871–872
Rizzoni G, Claris-Appiani A, Edefonti A, Facchin P, Franchini F, Gusmano R, Imbasciati E, Pavanello L, Perfumo F, Remuzzi G (1988) Plasma infusion for hemolytic-uremic syndrome in children: results of a multicenter controlled trial. J Pediatr 112: 284–290
Loirat C, Sonsino E, Hinglais N, Jais JP, Landais P, Fermanian J (1988) Treatment of the childhood haemolytic uraemic syndrome with plasma: a multicentre randomized controlled trial. Pediatr Nephrol 2: 279–285
Spencer CD, Crane FM, Kumar JR, Alving BM (1982) Treatment of postpartum hemolytic uremic syndrome with plasma exchange. JAMA 247: 2808–2809
Camba L, Al-Hilali MM, Shulji MMH, Joyner MV, Feest TG (1985) Haemolytic-uraemic-syndrome with renal failure: the effect of plasmapheresis. Haematologica 70: 341–344
Chow S, Roscoe J, Cattran DC (1986) Plasmapheresis and antiplatelet agents in the treatment of the hemolytic uremic syndrome secondary to mitomycin. Am J Kidney Dis 7: 407–412
Brenner BM, Dworkin LD, Ichikawa I (1986) Glomerular filtration. In: Brenner BM, Rector FC (eds) The kidney. Saunders, Philadelphia, pp 124–144
Manning RD (1987) Renal hemodynamic, fluid volume, and arterial pressure changes during hyperproteinemia. Am J Physiol 252: F403-F411
McLaine P, Marks M, Baliah T, Drummond K (1969) Hyperproteinemic proteinuria induced by plasma infusion. Pediatr Res 3: 597–604
Mori H, Yamashita H, Nakanishi C, Koizumi K, Makino S, Kishimota Y, Hayashi Y (1986) Proteinuria induced by transplantable rat pituitary tumor MtT SA5. Model for homologous protein-overload proteinuria. Lab Invest 54: 636–644
Eddy A, McCulloch L, Adams J (1988) Interstitial nephritis induced by protein-overload proteinuria. (Abstract) Kidney Int 33: 313
Maack T, Park CH, Camargo MJF (1985) Renal filtration, transport, and metabolism of proteins. In: Seldin DW, Giebisch G (eds) The kidney: physiology and pathophysiology. Raven Press, New York, pp 1773–1803
Zager RA, Teubner EJ, Adler S (1987) Low molecular weight proteinuria exacerbates experimental ischemic renal injury. Lab Invest 56: 180–188
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Eddy, A.A., Geary, D.F., Balfe, J.W. et al. Prolongation of acute renal failure in two patients with hemolytic-uremic syndrome due to excessive plasma infusion therapy. Pediatr Nephrol 3, 420–423 (1989). https://doi.org/10.1007/BF00850219
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DOI: https://doi.org/10.1007/BF00850219