Acute Phosphate Nephropathy with Diffuse Tubular Injury Despite Limited Calcium Phosphate Deposition

作者：Yamada Yosuke; Harada Makoto; Yamaguchi Akinori; Sugiyama Mai; Kanno Taro; Hashimoto Koji; Ehara Takashi; Shimojo Hisashi; Shigematsu Hidekazu; Kamijo Yuji^*

来源：Internal Medicine, 2016, 55(16): 2229-2235.

DOI：10.2169/internalmedicine.55.5864

• acute phosphate nephropathy
• oral sodium phosphate
• colonoscopy
• acute and reversible kidney injury
• calcium phosphate crystal
• drug-induced acute kidney injury

An 86-year-old woman developed acute kidney injury after colonoscopy. A renal biopsy showed diffuse tubular injury with minimal calcium phosphate deposits (CPDs), which were thought to be caused by an oral sodium phosphate bowel purgative before colonoscopy. According to these findings, she was diagnosed with acute phosphate nephropathy (APhN). In contrast to previous reports of diffuse tubular injury associated with tubular CPDs in APhN, this case demonstrated diffuse tubular injury despite a limited distribution of CPDs, suggesting that calcium phosphate can cause tubular injury without deposition. This case thus supports the hypothesis that urinary calcium phosphate crystals may cause tubular injury via other mechanisms, including inflammatory cytokines.

• 出版日期2016