Complications associated with continuous renal replacement therapy.

With the evolution of standardized replacement fluids, newer machines, and high flux membranes, continuous renal replacement therapy (CRRT) has made remarkable progress in the field of extracorporeal therapies. CRRT is the preferred dialytic modality for patients in intensive care unit setting (ICU). Standardized protocols are implemented by many institutions to avoid errors and ensure patient safety. However, complications related to CRRT are not uncommon. Understanding CRRT operations is essential to analyze the complications and further assist in developing measures to mitigate the risk. Overview of CRRT complications and potential preventive strategies are discussed in the current review.

Hepatitis C-associated focal proliferative glomerulonephritis in an aviremic recipient of a hepatitis C-positive antibody donor liver.

Shortage of organs for liver transplantation (LT) and the availability of highly efficient pan-genotypic direct-acting antivirals (DAAs) against hepatitis C virus (HCV) have allowed the use of livers from HCV-positive antibody/negative nucleic acid test donors (dHCV Ab+/NAT-) into aviremic HCV recipients over the last few years. We report the case of a patient who received an LT from an HCV Ab+/NAT- donor and, after HCV viremic conversion, developed a nephrotic syndrome due to a focal proliferative glomerulonephritis early after LT. Patient's renal function and proteinuria resolved after successful treatment with DAAs. Renal and hepatic function remain normal over 24 months of follow-up. This case restates the success of LT using livers from dHCV Ab+/NAT- in aviremic recipients in the context of DAAs while illustrating the risk for potential complications associated with the HCV transmission and reinforcing the importance of early initiation of anti-HCV therapy.