title: Efficacy of extracorporeal albumin dialysis for acute kidney injury due to cholestatic jaundice nephrotoxicity.
abstract: 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.
authors.affiliation: Department of Nephrology and Dialysis, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France Université Lyon 1, Villeurbanne, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Sens
authors.affiliation: Université Lyon 1, Villeurbanne, France Centre de Référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.
authors.forename: Justine
authors.initials: J
authors.lastname: Bacchetta
authors.affiliation: Department of Anatomopathology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors.forename: Maud
authors.initials: M
authors.lastname: Rabeyrin
authors.affiliation: Department of Nephrology and Dialysis, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France Université Lyon 1, Villeurbanne, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Juillard
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy*; D000328:Adult; D000418:Albumins / Q000627:therapeutic use; D001706:Biopsy; D002779:Cholestasis / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000150:complications*; D006801:Humans; D006932:Hyperbilirubinemia / Q000150:complications; D041781:Jaundice, Obstructive / Q000150:complications*; D007668:Kidney / Q000473:pathology; D016031:Liver Transplantation; D008297:Male; D009336:Necrosis; D006435:Renal Dialysis / Q000379:methods*
chemical_list: D000418:Albumins