Abstract
We experienced a case of adult hemolytic uremic syndrome (adult HUS) which was weaned from hemodialysis (HD) by plasmapheresis (PP) therapy. A 31-year-old male patient, who had high blood pressure for ten years, was admitted for evaluation of general malaise and dyspnea. He was diagnosed as having adult HUS based on microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Administration of antiplatelet and antihypertensive drugs, and HD therapy were begun immediately. Hemolytic anemia and thrombocytopenia gradually improved, but continuation of HD was required because of intractable oligo-anuria, which had developed, and persistent renal failure. Three months after onset, in hopes of improving his renal function, we tried PP therapy once week with HD. His daily urine output gradually increased and renal function improved. After the 9th course of PP therapy, the level of urine output, Ccr, and serum creatinine concentration had recovered to more than 1, 500ml/day, about 15.0ml/min, and 4.4mg/dl, respectively. About 7 months after onset, he was weaned from HD therapy and discharged from our hospital.
It is concluded that in the present case PP therapy was effective in treating intractable renal failure due to HUS.
