A patient with renal failure due to myeloma kidney and coincident digitalis intoxication due to prescribed daily digoxin administration was treated with digoxin-specific antibody fragments and plasmapheresis. Rapid response to therapy was noted, removal of digoxin-antidigoxin antibody complexes was confirmed, and prevention of delayed rebound toxicity was documented. We suggest that this is the therapy of choice in similar individuals.

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Acute renal failure in the critically ill patient is associated with high mortality. Often these patients are hemodynamically unstable, require judicious fluid management, and have a variety of electrolyte abnormalities and acid/ base disturbances. Therapeutic intervention is a necessity, but the patient may not tolerate an aggressive approach. Renal replacement therapies have advanced over the years to modalities that allow for improved management of the patient with acute renal failure. The content to follow will bring new promise to the treatment of acute renal failure employing continuous renal replacement therapy

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