• Clin Nephrol · May 2001

    Case Reports

    Hydroxyethyl starch-induced renal insufficiency after plasma exchange in a patient with polymyositis and liver cirrhosis.

    • S Peron, L Mouthon, C Guettier, S Brechignac, P Cohen, and L Guillevin.
    • Department of Internal Medicine, Hĵpital Avicenne and Assistance Publique Hĵpitaux de Paris, France.
    • Clin Nephrol. 2001 May 1; 55 (5): 408-11.

    AbstractHydroxyethyl starch (HES) is a macromolecular preparation that has been used as a volume expander since 1991. Renal toxicity of high-dose HES is now well recognized but potential renal toxicity of low-dose HES is poorly documented. Acute renal toxicity of cyclosporin A (CyA) may be responsible for osmotic nephrosis-like lesions. We report here the case of a 30-year-old male who developed cirrhosis due to hepatitis B and delta viruses and polymyositis. Polymyositis was treated with CyA, prednisone and plasma exchanges using low-dose HES as the replacement fluid. Renal insufficiency occurred with biopsy-proven osmotic nephrosis-like lesions, considered to be secondary to HES infusions and/or CyA.

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