[Bile salt nephropathy/cholemic nephrosis].
Bile cast nephropathy is a tubulo-interstitial nephropathy. Its diagnosis may be under-estimated. It develops in patients who have cholestatic jaundice, with high bilirubinemia. Bile salts are freely filtered through glomerulus. Under certain circumstances, it forms casts into the tubule and cause an acute tubular necrosis. The diagnosis evidence is histologic, but fulfilment of renal biopsy is often made difficult, because of the hemostatic abnormalities that patients with hepatocellular injury develop. The treatment is supportive and etiological. We report here the case of a patient who presented a drug-induced hepatic jaundice, complicated with acute kidney failure secondary to bile cast nephropathy. We present the histological diagnosis evidence.
Service de néphrologie, dialyse et transplantation, CUMR, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France.
Maxime
M
Leclerc
Service de néphrologie, dialyse et transplantation, CUMR, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France. Electronic address: antoine.lanot@gadz.org.
Antoine
A
Lanot
Service de néphrologie, dialyse et transplantation, CUMR, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France.
Clémence
C
Béchade
Laboratoire d'anatomie pathologie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France.
Cécile
C
Le Naoures
Laboratoire d'anatomie pathologie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France.
François
F
Comoz
Service de néphrologie, dialyse et transplantation, CUMR, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France.
Thierry
T
Lobbedez
D058186:Acute Kidney Injury / Q000175:diagnosis / Q000628:therapy; D000368:Aged; D000975:Antioxidants / Q000378:metabolism; D001647:Bile Acids and Salts / Q000378:metabolism; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D005765:Gastrointestinal Agents / Q000378:metabolism; D006801:Humans; D041781:Jaundice, Obstructive / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis* / Q000628:therapy*; D007684:Kidney Tubules / Q000187:drug effects / Q000473:pathology; D008297:Male; D009336:Necrosis; D009401:Nephrosis / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis* / Q000628:therapy*; D006435:Renal Dialysis / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome
D000975:Antioxidants; D001647:Bile Acids and Salts; D015415:Biomarkers; D005765:Gastrointestinal Agents; D001663:Bilirubin
Angiocholite urémigène; Bile cast nephropathy; Cholemic nephrosis; Cholestase; Jaundice; Jaundice-related kidney injury; Néphropathie cholémique; Néphropathie à cristaux biliaires; Néphropathie à cristaux de bilirubine