title: Bile Cast Nephropathy Caused by Obstructive Cholestasis.
abstract: Acute kidney injury (AKI) is a major complication in patients with liver disease. Although hepatorenal syndrome is frequently involved, bile cast nephropathy, characterized by tubular bile cast formation, has been scarcely described in the setting of severe liver failure. Few renal histology studies are available in these patients. We describe a case of bile cast nephropathy in a patient with obstructive cholestasis caused by stones in the common bile duct. The kidney biopsy confirmed this diagnosis, with several green casts in tubular lumens, tubular injury, and bilirubin composition of the tubular casts with Hall stain. The patient had no confounding cause of kidney failure, and complete kidney recovery followed removal of the bile duct obstruction. This case shows that severe cholestasis is sufficient to cause AKI, and that AKI can be reversible after treatment of the biliary obstruction.
authors: Nephrology, Dialysis and Transplantation Department, Gabriel Montpied University Hospital, Clermont-Ferrand, France. Electronic address: janiort@chu-clermontferrand.fr.
authors: Julien
authors: J
authors: Aniort
authors: Nephrology, Dialysis and Transplantation Department, Gabriel Montpied University Hospital, Clermont-Ferrand, France.
authors: Anaïs
authors: A
authors: Poyet
authors: Pathology Department, Gabriel Montpied University Hospital, Clermont-Ferrand, France.
authors: Jean-Louis
authors: JL
authors: Kemeny
authors: Nephrology, Dialysis and Transplantation Department, Gabriel Montpied University Hospital, Clermont-Ferrand, France.
authors: Carole
authors: C
authors: Philipponnet
authors: Nephrology, Dialysis and Transplantation Department, Gabriel Montpied University Hospital, Clermont-Ferrand, France.
authors: Anne-Elisabeth
authors: AE
authors: Heng
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D001646:Bile; D002779:Cholestasis / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: Cholestasis; acute kidney injury (AKI); bile cast nephropathy; bile duct obstruction; cholemic nephrosis; kidney biopsy; obstructive cholestasis; renal failure