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J Nephropathol. 2023;12(4): e21522.
doi: 10.34172/jnp.2023.21522

Scopus ID: 85172304452
  Abstract View: 456
  PDF Download: 190

Review

Bile cast nephropathy; a neglected entity

Rodrigo Alvarez 1 ORCID logo, Ramin Tolouian 2* ORCID logo

1 Department of Medicine, College of Medicine, University of Arizona, Tucson, USA
2 Renal Section, Southern Arizona VA Health Care System and College of Medicine, University of Arizona, Tucson, AZ, USA
*Corresponding Author: Ramin Tolouian, Email: ramin.tolouian@va.gov

Abstract

This study investigates the role of bile cast nephropathy (BCN) in acute kidney injury associated with cholestatic liver disease. Bile cast nephropathy is characterized by kidney injury due to, bile-related factors, distinct from hepatorenal syndrome (HRS) linked to hemodynamic changes in liver disease. The mechanisms of BCN include oxidative damage, tubular toxicity, and obstructive physiology. Diagnosis is typically through biopsy, although alternatives like trans-jugular biopsy are considered due to bleeding risks. Treatment targets underlying causes of hyperbilirubinemia, and extracorporeal therapies like plasmapheresis and molecular adsorbent recycling system show potential efficacy. Awareness and further research on noninvasive diagnostic methods for BCN are recommended.

Implication for health policy/practice/research/medical education:

Bile cast nephropathy (BCN) is characterized by kidney injury due to, bile-related factors, distinct from HRS linked to hemodynamic changes in liver disease. The mechanisms of BCN include oxidative damage, tubular toxicity, and tubular obstruction.

Please cite this paper as: Alvarez R, Tolouian R. Bile cast nephropathy; a neglected entity. J Nephropathol. 2023;12(4):e21522. DOI: 10.34172/jnp.2023.21522.

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Submitted: 13 Jul 2023
Accepted: 23 Aug 2023
ePublished: 17 Sep 2023
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