A case of acute kidney injury caused by oral sodium phosphate

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Author: PENG Qin ^1, ² WU Wenfeng ¹  WU Huiyi ¹

Affiliation: 1. Clinical Pharmacy Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China 2. Department of Clinical Pharmacy, The Second Clinical College of North Sichuan Medical College/Nanchong Central Hospital, Nanchong 637100, Sichuan Provice, China

Keywords: Sodium phosphate oral solution Acute kidney injury Hypertension Adverse drug reaction

DOI: 10.12173/j.issn.1005-0698.202406037

Reference: PENG Qin, WU Wenfeng, WU Huiyi.A case of acute kidney injury caused by oral sodium phosphate[J].Yaowu Liuxingbingxue Zazhi,2024, 33(10):1183-1188.DOI: 10.12173/j.issn.1005-0698.202406037.[Article in Chinese]  Copied

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Abstract

A 50-year-old hypertension male without high-risk factors related to acute kidney injury (AKI), took 90 mL oral sodium phosphates (OSP) solution for intestinal cleansing before the colonoscopy. After medication, severe diarrhea and vomiting appeared, with decreased blood pressure, anuria for 24 h, and serum creatinine increased from 87 µmol·L^-1 to 398 µmol·L^-1. Renal biopsy showed blue-purple calcium phosphate crystals were deposited in the renal tubules, the brush border disappeared and epithelial cell necrosis was necrotic or shed. The patient was diagnosed with AKI. According to Naranjo's Assessment Scale for adverse reactions, AKI was “probably” associated with the oral sodium phosphate. Subsequently, the patient was treated with prednisone acetate tablets, and serum creatinine was decreased significantly to 158 µmol·L^-1 2 months later. This case suggests that sodium phosphate preparation should be used with caution in hypertensive patients to avoid AKI.

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References

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