Cholemic Nephropathy as Cause of Acute and Chronic Kidney Disease. Update on an Under-Diagnosed Disease

Cholemic nephropathy (CN) is a recognized cause of acute kidney injury (AKI) in patients with severe hyperbilirubinemia (sHyb) and jaundice. Pathophysiological mechanisms of CN are not completely understood, but it seems caused both by direct toxicity of cholephiles and bile casts formation in nephr...

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Autores principales:	Francesca Tinti, Ilaria Umbro, Mariadomenica D’Alessandro, Silvia Lai, Manuela Merli, Annalisa Noce, Nicola Di Daniele, Sandro Mazzaferro, Anna Paola Mitterhofer
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	cholemic nephropathy acute kidney injury chronic kidney disease liver transplantation acute on chronic liver failure bile casts Science Q
Acceso en línea:	https://doaj.org/article/c71620a2ea4a46fe93b5c3496892ce20
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spelling	oai:doaj.org-article:c71620a2ea4a46fe93b5c3496892ce202021-11-25T18:11:07ZCholemic Nephropathy as Cause of Acute and Chronic Kidney Disease. Update on an Under-Diagnosed Disease10.3390/life111112002075-1729https://doaj.org/article/c71620a2ea4a46fe93b5c3496892ce202021-11-01T00:00:00Zhttps://www.mdpi.com/2075-1729/11/11/1200https://doaj.org/toc/2075-1729Cholemic nephropathy (CN) is a recognized cause of acute kidney injury (AKI) in patients with severe hyperbilirubinemia (sHyb) and jaundice. Pathophysiological mechanisms of CN are not completely understood, but it seems caused both by direct toxicity of cholephiles and bile casts formation in nephrons enhanced by prolonged exposure to sHyb, particularly in the presence of promoting factors, as highlighted by a literature reviewed and by personal experience. The aim of our update is to retrace CN in its pathophysiology, risk factors, diagnosis and treatment, underlining the role of sHyb, promoting factors, and CN-AKI diagnostic criteria in the different clinical settings associated with this often-concealed disease. Our purpose is to focus on clinical manifestation of CN, exploring the possible transition to CKD. Cholemic nephropathy is an overlooked clinical entity that enters differential diagnosis with other causes of AKI. Early diagnosis and treatment are essential because renal injury could be fully reversible as rapidly as bilirubin levels are reduced. In conclusion, our proposal is to introduce an alert for considering CN in diagnostic and prognostic scores that include bilirubin and/or creatinine with acute renal involvement, with the aim of early diagnosis and treatment of sHyb to reduce the burden on renal outcome.Francesca TintiIlaria UmbroMariadomenica D’AlessandroSilvia LaiManuela MerliAnnalisa NoceNicola Di DanieleSandro MazzaferroAnna Paola MitterhoferMDPI AGarticlecholemic nephropathyacute kidney injurychronic kidney diseaseliver transplantationacute on chronic liver failurebile castsScienceQENLife, Vol 11, Iss 1200, p 1200 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cholemic nephropathy acute kidney injury chronic kidney disease liver transplantation acute on chronic liver failure bile casts Science Q
spellingShingle	cholemic nephropathy acute kidney injury chronic kidney disease liver transplantation acute on chronic liver failure bile casts Science Q Francesca Tinti Ilaria Umbro Mariadomenica D’Alessandro Silvia Lai Manuela Merli Annalisa Noce Nicola Di Daniele Sandro Mazzaferro Anna Paola Mitterhofer Cholemic Nephropathy as Cause of Acute and Chronic Kidney Disease. Update on an Under-Diagnosed Disease
description	Cholemic nephropathy (CN) is a recognized cause of acute kidney injury (AKI) in patients with severe hyperbilirubinemia (sHyb) and jaundice. Pathophysiological mechanisms of CN are not completely understood, but it seems caused both by direct toxicity of cholephiles and bile casts formation in nephrons enhanced by prolonged exposure to sHyb, particularly in the presence of promoting factors, as highlighted by a literature reviewed and by personal experience. The aim of our update is to retrace CN in its pathophysiology, risk factors, diagnosis and treatment, underlining the role of sHyb, promoting factors, and CN-AKI diagnostic criteria in the different clinical settings associated with this often-concealed disease. Our purpose is to focus on clinical manifestation of CN, exploring the possible transition to CKD. Cholemic nephropathy is an overlooked clinical entity that enters differential diagnosis with other causes of AKI. Early diagnosis and treatment are essential because renal injury could be fully reversible as rapidly as bilirubin levels are reduced. In conclusion, our proposal is to introduce an alert for considering CN in diagnostic and prognostic scores that include bilirubin and/or creatinine with acute renal involvement, with the aim of early diagnosis and treatment of sHyb to reduce the burden on renal outcome.
format	article
author	Francesca Tinti Ilaria Umbro Mariadomenica D’Alessandro Silvia Lai Manuela Merli Annalisa Noce Nicola Di Daniele Sandro Mazzaferro Anna Paola Mitterhofer
author_facet	Francesca Tinti Ilaria Umbro Mariadomenica D’Alessandro Silvia Lai Manuela Merli Annalisa Noce Nicola Di Daniele Sandro Mazzaferro Anna Paola Mitterhofer
author_sort	Francesca Tinti
title	Cholemic Nephropathy as Cause of Acute and Chronic Kidney Disease. Update on an Under-Diagnosed Disease
title_short	Cholemic Nephropathy as Cause of Acute and Chronic Kidney Disease. Update on an Under-Diagnosed Disease
title_full	Cholemic Nephropathy as Cause of Acute and Chronic Kidney Disease. Update on an Under-Diagnosed Disease
title_fullStr	Cholemic Nephropathy as Cause of Acute and Chronic Kidney Disease. Update on an Under-Diagnosed Disease
title_full_unstemmed	Cholemic Nephropathy as Cause of Acute and Chronic Kidney Disease. Update on an Under-Diagnosed Disease
title_sort	cholemic nephropathy as cause of acute and chronic kidney disease. update on an under-diagnosed disease
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/c71620a2ea4a46fe93b5c3496892ce20
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Cholemic Nephropathy as Cause of Acute and Chronic Kidney Disease. Update on an Under-Diagnosed Disease

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