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The objective of the paper is to optimize the treatment of patients with severe hepatic-renal insufficiency using the method of plasma sorption (PS). PS (55) was performed in 26 patients: 12 men and 14 women. By age: up to 30 years - 2; to 40 - 1; up to 50-3; to 60 - 11; over 60 – 9 individuals. This group included patients with leptospirosis, toxic hepatitis, mechanical jaundice, pancreatic necrosis, sepsis, peritonitis, acute cholecystopancreatitis. PS was performed on the first 1-2 days of the patients’ admission to the intensive care unit against a background of oliguria or oligoanuria in a usual intermittent way.