Hemodialysis rescued the mother in a case of severe chronic renal failure accompanied by perirenal hematoma due to HELLP syndrome.

We present a case of severe maternal renal failure, accompanied by HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count). Since her renal function deteriorated in addition to the anemia and thrombocytopenia from 25 weeks' gestation, hemodialysis was performed three times a week. Unfortunately intra-uterine fetal death suddenly occurred at 30 weeks' gestation, and maternal right perirenal hematoma was diagnosed after delivery. The anemia and thrombocytopenia improved dramatically and the perirenal hematoma resolved uneventfully by late puerperium. The management of severe maternal renal failure with HELLP syndrome is described.