Hepato-renal bypass resulting in dialysis independence in case of acute renal failure

Abstract This case report describes a patient with bilateral renal artery occlusion resulting in the acute onset of refractory hypertension and renal failure requiring hemodialysis. Endovascular stenting of the renal arteries was not feasible given extensive aortic and renal orifice calcification. Following consultation with nephrology and medical optimization, the patient underwent unilateral hepato-renal bypass with subsequent improvement in renal function and sustained freedom from dialysis. Although percutaneous revascularization has become the preferred option for surgical management of renal artery occlusion, this case demonstrates that hepato-renal bypass remains a viable alternative for more complex cases.