Saudi Journal of Kidney Diseases and Transplantation

CASE REPORT
Year
: 2018  |  Volume : 29  |  Issue : 6  |  Page : 1498--1501

Bile cast nephropathy causing acute kidney injury in a patient with nonfulminant acute hepatitis A


Ranjani Ravi1, Kedar Suthar1, Praveen Murlidharan1, K Lakshmi2, Satish Balan1, Mohammed Safeer1 
1 Department of Nephrology, Kerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, India
2 Department of Pathology, Kerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, India

Correspondence Address:
Dr. Ranjani Ravi
Department of Nephrology, Kerala Institute of Medical Sciences, Anayara PO, Thiruvananthapuram -695 029, Kerala
India

Hepatitis A is usually a benign self-limiting disease with few or no extrahepatic manifestations. Acute hepatitis A causing severe renal dysfunction is not very common, although described. Patients developing renal dysfunction post hepatitis A infection usually have prerenal acute kidney injury (AKI) or acute tubular necrosis due to vomiting, diarrhea, and poor fluid replacement. However, if renal dysfunction persists, other causes need to be evaluated. The term cholemic nephrosis or more specifically bile cast nephropathy has been described in the setting of cholestatic jaundice and decompensated liver failure where bilirubin levels reach above 20 mg/dL. Herein, we describe the clinical course of a patient who developed acute hepatitis A with severe liver dysfunction and subsequently AKI which persisted for six weeks. Renal biopsy showed the evidence of bile cast nephropathy. After six weeks of hemodialysis, urine output improved. He slowly recovered both hepatic and renal functions.


How to cite this article:
Ravi R, Suthar K, Murlidharan P, Lakshmi K, Balan S, Safeer M. Bile cast nephropathy causing acute kidney injury in a patient with nonfulminant acute hepatitis A.Saudi J Kidney Dis Transpl 2018;29:1498-1501


How to cite this URL:
Ravi R, Suthar K, Murlidharan P, Lakshmi K, Balan S, Safeer M. Bile cast nephropathy causing acute kidney injury in a patient with nonfulminant acute hepatitis A. Saudi J Kidney Dis Transpl [serial online] 2018 [cited 2022 Jun 26 ];29:1498-1501
Available from: https://www.sjkdt.org/article.asp?issn=1319-2442;year=2018;volume=29;issue=6;spage=1498;epage=1501;aulast=Ravi;type=0