Acute Phosphate Nephropathy Successfully Treated with Hemodialysis: A Case Report and Literature Review
Yu-Ming Chang
Department of Internal Medicine, Division of Nephrology, Saint Mary’s Hospital Luodong, Taiwan
Chih-Chung Shiao *
Department of Internal Medicine, Division of Nephrology, Saint Mary’s Hospital Luodong, Taiwan and Saint Mary’s Medicine, Nursing and Management College, Yilan, Taiwan
Yuen-Hua Lei
Department of Orthopaedics, Saint Mary’s Hospital Luodong, Taiwan
Ching-Hua Huang
Department of Nursing, Saint Mary’s Hospital Luodong, Taiwan
Yu-Jing Wu
Department of Nursing, Saint Mary’s Hospital Luodong, Taiwan
*Author to whom correspondence should be addressed.
Abstract
Acute phosphate nephropathy is a kind of acute kidney injury resulted from oral sodium phosphate solutions which are hyperosmotic purgatives used for bowel cleansing before colonoscopy, contains a large amount of phosphorus and causes calcium phosphate crystals precipitation in the renal tubule. Acute phosphate nephropathy seems less reversible than other forms of acute tubulopathy and might predispose patients to chronic kidney disease. We reported a 53-year-old woman without underlying kidney disease developed acute phosphate nephropathy with a seizure after taking oral sodium phosphate solutions 45 ml per day for 4 days. A session of 4-hour hemodialysis was undertaken emergently for the symptomatic hypocalcemia and severe hyperphosphatemia, resulted in a prompt resolution of seizure. Her serum calcium and phosphate level, as well as a renal function also returned to normal ranges after supportive management for days. This case reminds physicians of risk factors and complications of acute phosphate nephropathy. Early hemodialysis may play a role in preventing untoward consequences.
Keywords: Acute phosphate nephropathy, hemodialysis, hypocalcemia, hyperphosphatemia, oral sodium phosphate solutions