Nephrotic Syndrome

Acute liver failure due to leptospirosis successfully treated with MARS (molecular adsorbent recirculating system) dialysis.

Int Urol Nephrol. 2007 Jan 3;

Covic A, Maftei ID, Gusbeth-Tatomir P.

Dialysis Center, "Dr. C. I. Parhon" University Hospital, Iasi, Romania,

BACKGROUND: Leptospirosis is a re-emerging infectious disease, which may lead to multiple organ failure (MOF)and death. CASE PRESENTATION: We report the first case of severe leptospirosis complicated with acute renal and liver failure, successfully treated with albumin dialysis--molecular adsorbent recirculating system (MARS).

Despite antibiotic therapy, optimum medical supportive treatment and timely initiated haemodialysis, the outcome was complicated by severe liver failure: hepatic encephalopathy grade III, hypoglycemia, prominent hyperbilirubinemia (TBIL 31.3 mg/dl, DBIL 28.6 mg/dl)and hepatic cytolysis (ALT 535 IU/l, AST 179 IU/l) and prolongation of the prothrombine time (68.4 sec). The patient underwent two sesions of albumin dialysis with the MARS procedure with complete recovery of hepatic and renal function. CONCLUSION: Albumin dialysis may confer a significant survival benefit on patients with leptospirosis-induced acute liver failure (ALF).