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Bile cast nephropathy: A case report and review of the literature

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Title: Bile cast nephropathy: A case report and review of the literature
Author(s): Patel, Jaymon; Walayat, Saqib; Kalva, Nikhil; Palmer-Hill, Sidney; Dhillon, Sonu
Subject(s): Bile cast Dialysis Drug-induced liver injury Hyperbilirubinemia Plasmapheresis
Abstract: Bile cast nephropathy is a condition of renal dysfunction in the setting of hyperbilirubinemia. There are very few cases of this condition reported in the last decade and a lack of established treatment guidelines. While the exact etiology remains unknown, bile cast nephropathy is presumed to be secondary to multiple concurrent insults to the kidney including direct toxicity from bile acids, obstructive physiology from bile casts, and systemic hypoperfusion from vasodilation. Therapy directed at bilirubin reduction may improve renal function, but will likely need dialysis or plasmapheresis as well. We report our case of bile cast nephropathy and the therapeutic measures undertaken in a middle-aged male with chronic renal insufficiency that developed hyperbilirubinemia and drug-induced liver injury secondary to antibiotic use. He developed acute renal injury in the setting of rising bilirubin. He subsequently had a progressive decline in renal and hepatic function, requiring dialysis and plasmapheresis with some improvement, ultimately requiring transplantation.
Issue Date: 2016-07-21
Publisher: Baishideng Publishing Group
Citation Info: Patel, Jaymon, Saqib Walayat, Nikhil Kalva, Sidney Palmer-Hill, and Sonu Dhillon. "Bile cast nephropathy: A case report and review of the literature." World Journal of Gastroenterology 22, no. 27 (2016): 6328. DOI: 10.3748/wjg.v22.i27.6328
Type: Article
Description: © The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
ISSN: 1007-9327
Date Available in INDIGO: 2016-09-14

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