What is acute phosphate nephropathy?
Acute phosphate nephropathy is seen in patients after exposure to oral sodium phosphate solutions (OSPS), which was used as a bowel cleanser in preparation for a colonoscopy.
Histopathologically, there is evidence of acute and chronic tubular injury with interstitial edema, accompanied by tubular atrophy and interstitial fibrosis.
The distinctive feature of this entity is the presence of abundant calcium phosphate deposits in the distal tubules and collecting ducts.
The following factors predispose patients to acute kidney failure: volume depletion, advanced age, hypertension, concurrent treatment with ACE-I or angiotensin receptor blockers, diuretics and NSAIDs, baseline creatinine elevation, or inappropriate use of OSPS in those with underlying CKD. In 2008, the US Food and Drug Administration released a boxed warning regarding the use of oral sodium phosphate products for bowel cleansing and the risk of AKI.
