Hemodialysis with a polyacrylonitril membrane is evaluated as a possible method to alleviate pruritus accompanying severe prolonged cholestasis. To that extent results of a series of 30 dialysis sessions of a patient with advanced primary biliary cirrhosis are reported. Efficacy is measured with a pruritus score, kept by the patient herself, as well as with pre- and postdialysis plasma bile acid concentrations and bile acid concentrations in dialysates. Bile acid removal can then be calculated in three different ways: (a) From the decrease of the plasma bile acid concentration by dialysis a figure of 300 μmol bile acid removed is estimated, (b) Measurements of bile acid concentration in the dialysates results in a figure of 666 ± (SD) 87 μmol bile acid removed, (c) From the mean pre- and postdialysis plasma bile acid concentrations together with an effective clearance rate of 8 ml/min for the bile acid mixture, calculated from ultrafiltration experiments, a removal of 589 ± 100 μmol bile acid is calculated. These figures compare favorably with figures reported in the literature for the alternative techniques used, plasmapheresis and plasma perfusion over activated charcoal.

Journal Section:
Case Report
Keywords:
Bile acids, Cholestasis, Pruritus, Polyacrylonitril, Hemodialysis
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© 1982 S. Karger AG, Basel
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1982
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