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A successful management of acute cholemic nephropathy secondary to acute liver abscess and pylephlebitis associated severe sepsis by ercp, combined cvvhdf and stepwise hemodialysis


Urology & Nephrology Open Access Journal
Nour  R Al-Khatib,1 Ali Awil Al,4  Renad Al-Shobaki,1 Salem M Bazarah,1 Nabih Hamad,2 Wail Tushkandi,2 Ahmed Akl1,3,5

Abstract

Cholemic nephrosis or yellow kidneys, is a rare condition and can be associated with acute kidney injury secondary to various etiologies. We are reporting a difficult case presented with  fatal  severe  sepsis  associated  with  hepatic,  pancreatic  and  renal  injury  secondary  to  impacted biliary stone at the ampulla of vater and complicated by infection. With proper management and early drainage of biliary system and continuous renal replacement therapy the patient survived. The early recognition and interference leads to reversal of symptoms and improvement of renal and patient survival.

Keywords

acute hepatitis, cholestatic hepatitis, septic shock, acute kidney injury, renal replacement therapy, ascending cholangitis

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