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Acute phosphate nephropathy-an emerging threat.
Yaacov Ori1, Michal Herman, Ana Tobar
1Department of Nephrology, Rabin Medical Center, Hasharon Hospital, Petah-Tikva, Israel. yakovo@clalit.org.il
The American Journal of the Medical Sciences
|October 16, 2008
Summary
Acute phosphate nephropathy (APN) is a serious kidney complication from oral sodium phosphate solution (OSPS). This condition often leads to irreversible renal failure, highlighting the need for increased awareness and risk factor management.
Area of Science:
- Nephrology
- Gastroenterology
- Pathology
Background:
- Acute phosphate nephropathy (APN) is a severe renal complication following oral sodium phosphate solution (OSPS) ingestion.
- While OSPS remains in use, only about 25 cases of APN have been documented.
- This study presents five additional cases, emphasizing the growing clinical significance of APN.
Purpose of the Study:
- To report and analyze five new cases of acute phosphate nephropathy (APN).
- To discuss the increasing importance and recognition of APN as a complication of oral sodium phosphate solution (OSPS).
Main Methods:
- Inclusion of five APN cases (3 retrospective, 2 prospective).
- Confirmation of OSPS use in all patients.
- Exclusion of alternative causes for nephrocalcinosis.
Main Results:
- Patients averaged 67.4 years, with a 4:1 female predominance; all had hypertension.
- Renal function impairment was observed, with creatinine levels rising post-colonoscopy.
- Histopathology revealed significant calcium-phosphate tubular deposition, interstitial fibrosis, and hypertensive changes; renal function did not fully recover in any patient.
Conclusions:
- Acute phosphate nephropathy (APN) is a severe and irreversible kidney complication linked to OSPS use.
- APN is likely underdiagnosed, with risk factors including female gender, advanced age, hypertension, and pre-existing renal issues.
- Even individuals with normal baseline renal function may develop APN after OSPS exposure.
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