关键词: 冷球蛋白血症肾损害, 连续性静脉—静脉血液透析, 滤器快速堵塞

Abstract:

Abstract：A 62 years old male was characterized by nephrotic syndrome with a large number of microscopic haematuria and elevated serum creatinine, associated with anemia, high level of cryoglobulin and immunoglobulin IgM, hyperviscosity syndrome, and thrombosis. Electrophoresis showed a monoclonal component which was classified as IgM kappa stripe. Bone biopsy examination indicated lymphocyte proliferation. The diagnose of renal damage due to cryoglobulinemia was made. After renal biopsy, the hemoglobin decreased quickly. Renal ultrasound showed the size of hematoma was 108mm×76mm. DSA examination was performed and then immediately treated with continuous veno-venos hemodialysis (CVVHD) therapy. During the treatment, pre-filtration pressure rised to 450mmHg immediately, the filter clogged quickly was considered, and then warmed arterial blood and the dialysate, the treatment could continued. After the CVVHD therapy for two times, the renal function was stable. Finally the patient got rid of continuous renal replacement therapy.

Key words: renal damage due to cryoglobulinemia,  continuous veno-venos hemodialysis therapy,  filter clogged quickly