A Case of Acute Phosphate Nephropathy after Colonoscopy

Abstract

Acute phosphate nephropathy is a form of acute kidney injury (AKI) due to oral sodium phosphate (ONaP) purgatives used for bowel cleansing before colonoscopy. Usually, 45 ml ONaP is given two times daily 12-24 hours prior to colonoscopy. Intestinal absorption is followed by transient hypocalcemia and hyperphosphatemia in almost all patients. In addition, severe hyperphosphatemia, symptomatic hypocalcemia, hypernatremia, hypocalcemia, hyponatremia, hypokalemia, high anion gap metabolic acidosis and AKI can be seen. The patient presented in this paper is a 65-year-old female. She was diagnosed with type 2 diabetes mellitus and hypertension. Colonoscopy was performed in order to investigate the etiology of iron deficiency anemia. ONaP was administered for preparation of colonoscopy and AKI which was clinically compatible with APN developed after the procedure. KEY wORdS: Acute phosphate nephropathy, Colonoscopy, Oral sodium phosphate doi: 10.5262/tndt.2013.1001.19 Yazisma Adresi: omer Celal ElCIOglu Saglik Bakanligi Istanbul Medeniyet Universitesi, Goztepe Egitim ve Arastirma Hastanesi, Nefroloji, Bilim Dali, Istanbul, Turkiye Tel : 0 212 570 92 87 E-posta : o.c.elcioglu@gmail.com Gelis Tarihi : 09.07.2012 Kabul Tarihi : 05.08.2012 dir. Ayrica ciddi hiperfosfatemi, semptomatik hipokalsemi, hipernatremi, semptomatik hiponatremi; hipokalemi, yuksek anyon acikli metabolik asidoz ve ABH gorulebilmektedir. Bu yazida ONaP ile kolonoskopi hazirligi yapildiktan sonra ABH gelismis bir