Akut fosfat nefropatisi: İki olgu sunumu ve literatürün gözden geçirilmesi

Öz

Fosfat nefropatisi; fosfat kristallerinin renal tübülleri etkilemesiyle oluşan önce akut, sonrasında kronik böbrek hasarı ile seyreden bir klinik tablodur. Kolonoskopi birçok endikasyonla sık olarak kullanılan bir yöntemdir. İşlem öncesinde hazırlık amaçlı kullanılan oral fosfat içerikli pürgatifler bu tablonun gelişimine yol açmaktadır. Nefropati gelişme riski yüksek olan gruplarda, fosfat içermeyen pürgatiflerin kullanılması önerilmektedir. Fosfat nefropatisi tedavisinde temel yaklaşım hasarın gelişimini önlemektir. Biz bu yazımızda, oral sodyum fosfat ile kolonoskopi yapılan ve işlem sonrası fosfat nefropatisi ile uyumlu akut böbrek hasarı gelişen iki vakayı sunmayı amaçladık.

Anahtar Kelimeler

• Fosfat nefropatisi
• kolonoskopi
• pürgatif

Acute phosphate nephropathy: Two case reports and review of the literature

Öz

Phosphate nephropathy is a clinical picture that occurs with the effect of phosphate crystals on the renal tubules, which first progresses with acute and then chronic kidney damage. Colonoscopy is a method for direct examination of the colon performed with various indications. Oral phosphate-containing purgatives used for preparatory purposes before this procedure lead to the development of this disease. In groups with a high risk of developing nephropathy, phosphate-free purgatives are recommended during the preparation for the colonoscopy. The principal treatment for phosphate nephropathy is to prevent the development of damage. In this article, we aimed to present two cases of phosphate nephropathy who underwent colonoscopy for different indications and that oral phosphate was used during the preparation for the procedure.

Anahtar Kelimeler

• Phosphate nephropathy
• colonoscopy
• purgative

Kaynakça

1. 1. Balaban DH. Guidelines for the safe and effective use of sodium phosphate solution for bowel cleansing prior to colonoscopy. Gastroenterol Nurs 2008;31:327-34.
2. 2. Gumurdulu Y, Serin E, Ozer B, Gokcel A, Boyacioglu S. Age as a predictor of hyperphosphatemia after oral phosphosoda administration for colon preparation. J Gastroenterol Hepatol 2004;19:68-72.
3. 3. Markowitz GS, Nasr SH, Klein P, et al. Renal failure due to acute nephrocalcinosis following oral sodium phosphate bowel cleansing. Hum Pathol 2004;35:675-84.
4. 4. Jimenez C, Gagel RF. Disorders Affecting Multipl Endocrine Systems. In: Fauci AS, Braunweld E, Kasper DL (eds.), Harrison’s Principles of Internal Medicine. 17th ed. New York: McGraw-Hill Co; 2013. p.2371-2.
5. 5. Asplin JR, Mandel NS, Coe FL. Evidence of calcium phosphate supersaturation in the loop of Henle. Am J Physiol 1996;270:F604-F13.
6. 6. Markowitz GS, Stokes MB, Radhakrishnan J, D’Agati VD. Acute phosphate nephropathy following oral sodium phosphate bowel purgative: An underrecognized cause of chronic renal failure. J Am Soc Nephrol 2005;16:3389-96.
7. 7. Tan JJ, Tjandra JJ. Which is the optimal bowel preparation for colonoscopy-a meta-analysis. Colorectal Dis. 2006;8:247-58.
8. 8. Aydınlı F, Ahıshalı E, Dolapçıoğlu C, Uygur MM, Dabak R. Evaluation of the safety and afficacy of colonoscopy preparation by sodium phosphate in patients with normal creatinin values. J Kartal TR 2011;22:113-20.

9. 9. Hookey LC, Depew WT, Vanner S. The safety profile of oral sodium phosphate for colonic cleansing before colonoscopy in adults. Gastrointest Endosc 2002;56:895-902.
10. 10. Barclay RL. Safety, efficacy, and patient tolerance of a three-dose regimen of orally administered aqueous sodium phosphate for colonic cleansing before colonoscopy. Gastrointest Endosc 2004;60:527-33.