Sodium phosphate
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Kidney disorders in an elderly patient: case report A 69-year-old woman with membranous glomerulonephritis developed acute phosphate kidney disorder after receiving oral sodium phosphate for bowel cleansing in preparation for colonoscopy. The woman received two doses of sodium phosphate 45mL [dose not clearly stated], one the evening before and one the morning of colonoscopy. The next day, at a scheduled visit with her nephrologist, she reported nausea and was hospitalised. She had a BP of 173/96mm Hg and laboratory tests revealed the following results: phosphate 2.2 mmol/L, creatinine 382 µmol/L, albumin 36 g/L, calcium 2.2 mol/L. Over the next 5 days, her creatinine level increased to 528 µmol/L and a biopsy was taken; medications at this time were losartan/hydrochlorothiazide, levothyroxine-sodium, bumetanide, aspirin, amlodipine, atorvastatin, prednisolone and calcium/colecalciferol. A biopsy confirmed the initial diagnosis of membranous glomerulonephritis and revealed calcium phosphate deposits in tubular cells, and interstitial oedema; a biopsy 2 months earlier had not shown signs of calcium deposits. Her elevated phosphate level persisted for 11 days. During the following months, her creatinine level decreased and remained at approximately 150 µmol/L for the next 3.5 years. Author comment: "[A] biopsy taken only 2 months before the acute kidney disease showed no sign of the calcium phosphate deposits found in the second biopsy. We therefore conclude that the phosphate load given to the patient caused the findings in the second biopsy." Aasebø W, et al. Kidney biopsies taken before and after oral sodium phosphate bowel cleansing. Nephrology Dialysis Transplantation 22: 920-922, No. 3, Mar 801070555 2007 - Norway
0114-9954/10/1146-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 7 Apr 2007 No. 1146
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