Bile cast nephropathy (BCN) or cholemic nephropathy (CN) is an acute renal dysfunction, including acute kidney injury (AKI) in the setting of liver injury. It is a common phenomenon in patients with liver disease and is associated with significant morbidity and mortality. CN is characterized by hemodynamic changes in the liver, kidney, systemic circulation, intratubular cast formation, and tubular epithelial cell injury. CN has been overlooked as a differential diagnosis in chronic liver disease patients due to more importance to hepatic injury. However, frequent and considerable reporting of case reports recently has further investigated this topic in the last two decades. This review determines the evidence behind the potential role of bile acids and bilirubin in acute renal dysfunction in liver injury, summarizing the implied pathophysiology risk factors, and incorporating the therapeutic mechanisms and outcomes.
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| http://dx.doi.org/10.7759/cureus.23606 | DOI Listing |
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Introduction: Cholemic nephropathy is an overlooked cause of acute kidney injury (AKI) in patients with advanced cirrhosis and high bilirubin plasma levels (usually above 20mg/dl), due to bilirubin and bile acid deposition in the kidneys. Those deposits have been hypothesized to cause tubular injury. It has no standardized diagnostic criteria or therapeutic strategies.
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Am J Surg Pathol
January 2025
Division of Pathology.
Article Synopsis
- A study of 121 cases of small duct-type intrahepatic cholangiocarcinoma (small duct-iCCA) identified intraductal polypoid neoplasms in 8 cases (6.6%), which showed growth patterns adjacent to mass-forming tumors.
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BMJ Case Rep
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- Hepatitis A virus (HAV) usually causes mild illness but can lead to severe complications like acute liver failure, which is fatal in rare cases; in 2016, it resulted in about 7,134 deaths.
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World J Gastrointest Oncol
May 2024
Second Department of Gastroenterology, Digestive Disease Hospital of Heilongjiang Provincial Hospital, and Heilongjiang Provincial Clinical Medical Research Center for Minimally Invasive Diagnosis and Treatment of Pancreaticobiliary Diseases, Harbin 150001, Heilongjiang Province, China.
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