Plasma exchange and double plasma molecular adsorption system combined with continuous renal replacement therapy for hepatitis B-related liver failure complicated by stage 3 acute kidney injury: a case report

The article describes a case of a 27-year-old woman with severe hepatitis B-related liver failure complicated by stage 3 acute kidney injury. The patient presented with fatigue, dark urine, and jaundice, with an HBV DNA level of 3.57 × 10⁶ copies/mL. During hospitalization, serum creatinine increased from 96 μmol/L on day 1 to 825 μmol/L on day 4, with worsening coagulation and bilirubin levels. The patient developed hypersomnia and impaired consciousness. Treatment included plasma exchange combined with a double plasma molecular adsorption system for liver support and continuous renal replacement therapy. Following treatment, consciousness, coagulation, and liver and kidney function improved. The patient left the intensive care unit on day 7 and was discharged on day 24 with normal liver and kidney function at follow-up.