Bile cast nephropathy:A systematic review of case reports and case series  

作　　者：Iyiad Alabdul Razzak Hind El Naamani Dimo Dimitrov Rebecca Morin Bertrand L Jaber 

机构地区：[1]Department of Medicine,Beth Israel Deaconess Medical Center,Harvard Medical School,Boston,MA 02115,United States [2]Department of Medicine,St.Elizabeth’s Medical Center,Boston,MA 02135,United States [3]Department of Research and Instruction,Tufts University,Boston,MA 02111,United States

出　　处：《World Journal of Hepatology》2025年第4期105-119,共15页世界肝病学杂志(英文)

摘　　要：BACKGROUND Bile cast nephropathy(BCN)is suspected in the setting of liver disease and hyperbilirubinemia and is characterized by the formation of tubular bile casts and acute tubular injury.While postmortem studies reveal a high prevalence of BCN,little is known about this orphan acute kidney injury syndrome.AIM To address this knowledge gap,we performed a systematic review of case reports and case series of BCN,focusing on risk factors,diagnostic criteria,clinical presentation,kidney biopsy findings,severity,treatment approaches,and outcomes.METHODS Electronic databases were searched to identify eligible studies of patients with possible,probable,or definite BCN,using pre-established criteria.Relevant variables were extracted and analyzed.We explored the impact of serum total bilirubin levels and alcoholic liver disease on BCN severity and outcomes by stratifying cases into total bilirubin tertiles and alcoholic vs non-alcoholic liver disease.Univariate and multivariable logistic regression analyses were used to examine factors associated with the composite outcome of dialysis requirement or death.RESULTS Sixty-seven case reports and six case series(involving 2 patients each)met the inclusion criteria,totaling 79 cases of BCN.The mean age was 48.3 years,and 83.5%were men.The most common cause of liver disease was drug-induced injury(30.4%),followed by infection(18.9%)and alcoholism(12.7%).BCN diagnosis was deemed definite,probable,and possible in 65.8%,32.9%,and 1.3%of cases,respectively.Levels of serum creatinine,dialysis requirement,and renal recovery did not differ among the total bilirubin tertile groups.However,both initial and peak serum creatinine were significantly higher in the alcoholic liver disease group compared to the non-alcoholic group(P=0.011 and P=0.012,respectively).There was also a non-significant trend toward a higher incidence of dialysis requirement or death in the alcoholic liver disease group(80%vs 52%,P=0.098).Finally,higher initial serum creatinine(per 1 mg/dL increase)was independentl

关 键 词：Cholemic nephropathy Acute kidney injury Liver disease Bile acids Oxidative stress Kidney biopsy Prognostic factors OUTCOMES 

分 类 号：R692[医药卫生—泌尿科学]