Related Experiment Video
Updated: Mar 23, 2026
08:56
Bile Duct Ligation in Mice: Induction of Inflammatory Liver Injury and Fibrosis by Obstructive Cholestasis
Published on: February 10, 2015
55.2K
Bile Nephropathy in Flucloxacillin-Induced Cholestatic Liver Dysfunction
Basil Alnasrallah1, John F Collins1, L Jonathan Zwi2
1Department of Nephrology, Auckland City Hospital, Auckland 1023, New Zealand.
Case Reports in Nephrology
|March 24, 2016
Summary
Severe acute kidney injury (AKI) can result from cholestatic liver dysfunction. This case highlights bile nephropathy, characterized by bile casts, and reviews current literature on this kidney injury.
Area of Science:
- Nephrology
- Hepatology
- Internal Medicine
Background:
- Cholestatic liver dysfunction can lead to kidney injury, historically termed 'cholemic nephrosis'.
- Skepticism regarding the direct role of bile in renal injury has diminished the use of this term.
- Recent literature suggests a potential revival of the concept of bile nephropathy.
Purpose of the Study:
- To describe a case of severe acute kidney injury (AKI) caused by bile nephropathy.
- To investigate the role of bile casts in flucloxacillin-induced liver dysfunction and subsequent kidney injury.
- To review and discuss recent literature on bile nephropathy.
Main Methods:
- Case report of a patient with severe AKI and cholestatic liver dysfunction.
- Histopathological examination revealing bile casts in renal tubules.
- Literature review of studies on bile nephropathy and kidney injury in cholestasis.
Main Results:
- The patient presented with severe AKI in the setting of flucloxacillin-induced liver dysfunction.
- Bile casts were identified in the renal tubules, supporting the diagnosis of bile nephropathy.
- Literature review indicates a renewed interest in the understanding of bile's role in kidney injury.
Conclusions:
- Bile nephropathy, evidenced by bile casts, is a significant cause of AKI in cholestatic liver dysfunction.
- This case and recent literature support the re-evaluation of bile's direct impact on renal function.
- Further research is warranted to elucidate the mechanisms of bile nephropathy.
Related Concept Videos
01:26Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
333
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
333
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
459
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
459
01:17Chronic Bowel Disorders: Introduction
896
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
896
01:28Inhibitors of Bacterial DNA Synthesis
17
Bacterial pathogens depend on precise and efficient DNA replication to sustain infection. Two type II topoisomerases—DNA gyrase and topoisomerase IV—are critical to this process, as they resolve DNA supercoiling and unlink chromosomes during replication. Fluoroquinolones, synthetic derivatives of quinolones, exploit this mechanism by stabilizing the transient DNA–enzyme cleavage complex, preventing strand religation, and causing lethal double-strand breaks. These...
17
01:17Hepatic Drug Excretion: Enterohepatic Cycling
3.3K
Enterohepatic cycling involves the active secretion of drugs and their metabolites into the bile via transporters in the canalicular membrane of hepatocytes. This secretion is an integral part of the digestive process, releasing these substances into the gastrointestinal (GI) tract.
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
3.3K
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
256
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
256