磷酸钠盐口服溶液致急性磷酸盐肾病

Acute phosphate nephropathy induced by sodium phosphates oral solution

1例55岁既往有高血压病和2型糖尿病的男性患者在肠镜检查前日晚和当日晨以磷酸钠盐口服溶液45 ml加入750 ml以上温水稀释后服用2次行肠道准备。肠镜检查后,患者出现腹部胀满症状,18 d后发现血清肌酐(Scr)升高,峰值达175μmol/L。肠镜检查35 d后Scr 168μmol/L,采用慢性肾脏病流行病学合作研究组肌酐公式计算肾小球滤过率为38.54 ml/min。肾穿刺病理示肾小管上皮细胞损伤伴磷酸钙沉积,诊断为急性磷酸盐肾病。建议患者多饮水,给予呋塞米利尿等对症治疗,5个月后Scr恢复至105μmol/L。

A 55-year-old male patient with a history of hypertension and type 2 diabetes mellitus received sodium phosphates oral solution 45 ml diluted in 750 ml or more warm water in 2 divided doses for bowel cleansing on the night before and the morning of the day of colonoscopy.After the colonoscopy,the patient developed abdominal distension.Eighteen days after the colonoscopy,elevated serum creatinine(Scr)was found with a peak value of 175μmol/L.Thirty-five days after the colonoscopy,Scr was 168μmol/L and the glomerular filtration rate calculated by the plasma-creatinine-based equations Chronic Kidney Disease Epidemiology Collaboration was 38.54 ml/min.Renal puncture and pathological examination showed tubular epithelial cell injury with calcium phosphate deposits,and acute phosphate nephropathy was diagnosed.The patient was advised to drink more water and was given symptomatic treatments such as diuretic furosemide.Five months later,the Scr recovered to 105μmol/L.