A 43‐year‐old Chinese man with chronic viral hepatitis and end‐stage renal disease, receiving conventional hemodialysis for 6 years, presented with general malaise and abdominal fullness. After
4.5 hours of hemodialysis, the hollow fibers of the dialyzer turned yellow. Biochemistry studies showed hyperbilirubinemia. The actual serum bilirubin (7.4 mg/dL) could be proved. Abdominal echography survey was negative. Hyperbilirubinemia was secondary to acute exacerbation of chronic
viral hepatitis. Anuria and skin hyperpigmentation in uremia lack the tea‐color urine and mask clinical jaundice in the presence of hyperbilirubinemia. Careful observation of dialyzer yellowish discoloration gave us timely discovery of patient's hyperbilirubinemia.
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