Bile acid-induced cholemic nephropathy

Dig Dis. 2015;33(3):367-75. doi: 10.1159/000371689. Epub 2015 May 27.

Abstract

Kidney injury in deeply jaundiced patients became known as cholemic nephropathy. This umbrella term covers impaired renal function in cholestatic patients with characteristic histomorphological changes including intratubular cast formation and tubular epithelial cell injury. Cholemic nephropathy represents a widely underestimated but important cause of kidney dysfunction in patients with cholestasis and advanced liver disease. However, the nomenclature is inconsistent since there are numerous synonyms used; the underlying mechanisms of cholemic nephropathy are not entirely clear, and widely accepted diagnostic criteria are still missing. Consequently, the current article aims to summarize the present knowledge on the clinical and morphological characteristics, available preclinical models, derived potential pathomechanisms, and future diagnostic and therapeutic strategies in cholemic nephropathy. Furthermore, we provide a potential research agenda for this evolving field.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Kidney Injury / etiology
  • Bile Acids and Salts / metabolism*
  • Cholestasis / complications*
  • Cholestasis / metabolism
  • Hepatorenal Syndrome / etiology
  • Humans
  • Jaundice, Obstructive / complications*
  • Jaundice, Obstructive / metabolism
  • Kidney Diseases / etiology*
  • Kidney Diseases / pathology*
  • Terminology as Topic

Substances

  • Bile Acids and Salts