Weiss Jessica, Thorp Micah L
Division of Nephrology, Oregon and Health and Sciences University, Portland, Oregon, USA.
BMJ Case Rep. 2011 May 3;2011:bcr0420102876. doi: 10.1136/bcr.04.2010.2876.
Acute phosphate nephropathy occurs whenever a patient with renal dysfunction is exposed to high doses of phosphate. Bowel purgative agents are a common source of high doses of sodium phosphate and are widely used as bowel preparation agents prior to colonoscopy due to their efficacy and tolerability. Oral sodium phosphate (OSP) preparations used to prepare patients for colonoscopy may be a cause of acute and chronic kidney disease (CKD). CKD associated with OSP agents is the result of nephrocalcinosis, or calcium phosphorus crystal deposition in the renal parenchyma leading to interstitial disease. It is often irreversible and progressive in nature. The authors report a case of CKD which presented with non-specific symptoms weeks after use of an OSP agent as part of a bowel preparation regimen. Renal biopsy confirmed nephrocalcinosis.
急性磷酸盐肾病在任何肾功能不全患者接触高剂量磷酸盐时都会发生。肠道泻药是高剂量磷酸钠的常见来源，由于其有效性和耐受性，被广泛用作结肠镜检查前的肠道准备剂。用于为结肠镜检查患者做准备的口服磷酸钠（OSP）制剂可能是急性和慢性肾病（CKD）的一个原因。与OSP制剂相关的CKD是肾钙质沉着症的结果，即钙磷晶体在肾实质中沉积导致间质疾病。它通常是不可逆的且呈进行性发展。作者报告了一例CKD病例，该病例在作为肠道准备方案的一部分使用OSP制剂数周后出现非特异性症状。肾活检证实为肾钙质沉着症。
