ABSTRACT
Oral sodium phosphate (OSP) solutions are widely used for bowel cleansing before colonoscopy, for stercoral retention phenomena and persistent chronic constipation. Its main risk, is acute phosphate nephropathy (APN), which is a clinic-pathological entity characterized by acute kidney disease secondary to deposition of calcium phosphate crystals in the renal tubules. Its recognition has been documented over the last decade in relation to case reports and the warning of the FDA. This report discusses two cases of APN certified by renal biopsy after the administration of OSP. One of them had an acute symptomatic presentation, and the other one, was a late finding. Both developed renal failure.
Las soluciones de fosfato de sodio oral (FSO) son ampliamente utilizadas para la preparación de colon previo a colonoscopia, para fenómenos de retención estercorácea y constipación crónica pertinaz. Su principal riesgo, la nefropatía aguda por fosfatos (NAF), es una entidad clínico-patológica caracterizada por falla renal aguda secundaria a depósito de cristales de fosfato de calcio en los túbulos renales. En la última década se han comunicado reportes de casos clínicos y una advertencia del uso de FSO por parte de la Food and Drug Administration de EE.UU. (FDA). En esta publicación se comunican dos casos de NAF, posterior a la administración de FSO, confirmadas por biopsia. Uno de ellos tuvo una presentación aguda y sintomática y el otro fue un hallazgo tardío. Ambos se acompañaron de falla renal.
Subject(s)
Female , Humans , Middle Aged , Aged , Acute Kidney Injury/chemically induced , Colonoscopy/methods , Phosphates/adverse effects , Preoperative Care , Administration, Oral , Kidney Diseases/chemically induced , Phosphates/administration & dosageABSTRACT
The most successful therapy for acute liver failure is liver transplantation. However, due to the low number of donors, organ support therapies need to be used as a bridge to liver transplantation. Molecular Adsorbents Recirculating System (MARS) is a dialysis treatment that uses a recirculating dialysate containing albumin. This allows the removal of both hydrosoluble and albumin-related substances. This system improves hepatic encephalopathy, renal dysfunction and some clinical parameters in acute liver failure, but there is no clear decrease in mortality. We report three women aged 23, 21 and 61 years, that were subjected to liver transplantation, in whom this therapy was successfully used.