口服磷酸钠盐致急性肾损伤1例  

A case of acute kidney injury caused by oral sodium phosphate

作　　者：彭勤 吴文锋 吴慧仪[1] PENG Qin;WU Wenfeng;WU Huiyi(Clinical Pharmacy Center,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Clinical Pharmacy,The Second Clinical College of North Sichuan Medical College/Nanchong Central Hospital,Nanchong 637100,Sichuan Provice,China)

机构地区：[1]南方医科大学南方医院临床药学中心,广州510515 [2]川北医学院第二临床医学院/南充市中心医院临床药学科,四川南充637100

出　　处：《药物流行病学杂志》2024年第10期1183-1188,共6页Chinese Journal of Pharmacoepidemiology

基　　金：广东省医院协会药学科研专项基金(2022YXKY14);南方医科大学南方医院院长基金(2020C034)。

摘　　要：1例50岁男性高血压患者,排除相关高危因素,行肠镜检查前服用磷酸钠盐口服溶液90 mL用于肠道清洁,服药后出现多次严重腹泄、呕吐,伴血压下降、24 h无尿等症状,血肌酐从87μmol·L^(-1)上升至398μmol·L^(-1),肾脏病理表现为蓝紫色磷酸钙结晶在肾小管中沉积,小管刷状缘脱落、上皮细胞坏死或脱落,诊断为急性肾损伤。采用Naranjo's评估量表进行评价,考虑口服磷酸钠盐溶液致急性肾损伤的关联性为“很可能有关”。予以醋酸泼尼松片治疗,2个月后血肌酐下降至158μmol·L^(-1)。本病例提示,高血压人群应谨慎使用磷酸钠盐制剂,避免急性肾损伤的发生。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 87μmol·L^(-1) to 398μmol·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 158μmol·L^(-1)2 months later.This case suggests that sodium phosphate preparation should be used with caution in hypertensive patients to avoid AKI.

关 键 词：磷酸钠盐口服溶液 急性肾损伤 高血压 药品不良反应 

分 类 号：R969[医药卫生—药理学]