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Renal failure due to acute phosphate nephropathy
T M Slee1, L J Vleming, R M Valentijn
1Department of Internal Medicine, Leiden University Medical Centre, Leiden, the Netherlands.
The Netherlands Journal of Medicine
|November 18, 2008
Summary
Oral sodium phosphate solution for bowel cleansing can cause acute phosphate nephropathy, leading to chronic kidney disease. Physicians should avoid prescribing it to patients with risk factors like hypertension or advanced age.
Area of Science:
- Nephrology
- Gastroenterology
Background:
- Oral sodium phosphate solutions are commonly used for bowel preparation before colonoscopy.
- Acute phosphate nephropathy is a rare but serious complication associated with these solutions.
Observation:
- A 62-year-old woman developed acute renal failure due to nephrocalcinosis after using oral sodium phosphate solution for bowel cleansing.
- Her renal insufficiency partially resolved, leading to stage 4 chronic kidney disease.
Findings:
- The patient had multiple risk factors including hypertension, diuretic use, angiotensin-II receptor blocker use, female gender, advanced age, and volume depletion from vomiting and nausea.
- These risk factors likely contributed to the development of acute and chronic renal failure.
Implications:
- Physicians should carefully consider patient risk factors before prescribing oral sodium phosphate solutions.
- Avoiding these solutions in patients with risk factors may prevent acute and chronic renal failure.
- Further research is needed to identify all potential risk factors and the exact mechanism of this complication.
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