Renal Failure Associated with Low-molecular-weight Dextran Infusion

Abstract

Three cases of profound oliguria following courses of lowmolecular- weight dextran are reported. Two patients had generalized vascular disease but no other evidence of renal involvement. All were given adequate fluids during treatment and none suffered episodes of hypotension. Renal biopsy material was obtained from each case, and a florid form of “osmotic nephrosis” was noted in each. There was no evidence that oliguria was due to intraluminal aggregations of dextran; rather it seemed that either luminal compromise by greatly distended tubular cells or cellular impairment by contained dextran was responsible. The value of low-molecularweight dextran in such cases is uncertain, but it is obvious that prolonged courses should be employed with the utmost caution if they are to be used at all. © 1966, British Medical Journal Publishing Group. All rights reserved.