RRT in Liver Failure

  • Vimal Chadha
  • Bradley A. WaradyEmail author


A 5-year-old boy was seen in the outpatient clinic for evaluation of yellow discoloration of his eyes and skin for the past 2–3 days. His parents reported that his appetite has decreased over the past 1 week and he had been complaining of generalized abdominal discomfort. On examination, he had scleral and cutaneous icterus. His abdomen was distended, and his liver was palpable 3 cm below the costal margin; it was firm and mildly tender. His blood tests revealed hemoglobin 10.7 g/dL, WBC count 6560/mm3, platelet count 168,000/mm3, sodium 140 mEq/L, potassium 4.1 mEq/L, chloride 105 mEq/L, bicarbonate 23 mEq/L, urea nitrogen 4 mg/dL, creatinine 0.37 mg/dL, calcium 9.5 mg/dL, glucose 93 mg/dL, albumin 4 g/dL, bilirubin 13.1 (conjugated 11.7) mg/dL, AST 4410 U/L, ALT 2858 U/L, GGT 155 U/L, and alkaline phosphatase 435 U/L. Imaging studies (ultrasound and MRCP) confirmed hepatosplenomegaly and showed a thickened gall bladder and a normal caliber common bile duct, in addition to mild to moderate ascites. He was hospitalized for a day and then followed as an outpatient. Tests for viral studies and alpha-1 antitrypsin came back negative.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of PediatricsUniversity of Missouri–Kansas City School of MedicineKansas CityUSA
  2. 2.Division of Pediatric NephrologyChildren’s Mercy Kansas CityKansas CityUSA

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