title: A case of acute phosphate nephropathy in a patient with nephrotic syndrome and decreased serum fetuin-A.
abstract: We report a case of APN after OSP use in a patient with nephrotic syndrome (NS). Renal biopsy revealed minimal change disease with multifocal calcium phosphate deposits within the tubules and in the interstitium. The serum level of fetuin-A, a systemic calcification inhibitor, was low during severely proteinuric state but normalized after remission of NS. To verify whether fetuin-A levels are low in NS patients, serum fetuin-A levels were determined in 10 patients with NS and 10 with asymptomatic microscopic hematuria (H). The mean serum fetuin-A levels were significantly lower in the NS group compared to the H group (p < 0.01). This finding suggests that a lower serum fetuin-A level may be associated with APN after OSP use in patients with NS, thus careful attention should be paid when colonoscopy using OSP is scheduled in this population.
authors.affiliation: Department of Internal Medicine, College of Medicine, Brain Korea 21 Project for Medical Science, Yonsei University, Seoul, Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Han
authors.forename: J E
authors.initials: JE
authors.lastname: Lee
authors.forename: S H
authors.initials: SH
authors.lastname: Lee
authors.forename: J J
authors.initials: JJ
authors.lastname: Li
authors.forename: S W
authors.initials: SW
authors.lastname: Hong
authors.forename: D S
authors.initials: DS
authors.lastname: Han
authors.forename: S-W
authors.initials: SW
authors.lastname: Kang
mesh_terms: D000208:Acute Disease; D058186:Acute Kidney Injury / Q000139:chemically induced*; D000284:Administration, Oral; D001706:Biopsy; D001798:Blood Proteins / Q000378:metabolism*; D002400:Cathartics / Q000008:administration & dosage / Q000009:adverse effects*; D003113:Colonoscopy; D003404:Creatinine / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000150:complications*; D010710:Phosphates / Q000008:administration & dosage / Q000009:adverse effects*; D060749:alpha-2-HS-Glycoprotein
chemical_list: C556354:AHSG protein, human; D001798:Blood Proteins; D002400:Cathartics; D010710:Phosphates; D060749:alpha-2-HS-Glycoprotein; D003404:Creatinine; C018279:sodium phosphate