ABSTRACT
Acute phosphate nephropathy is a rare, but serious adverse event associated with the use of sodium phosphate for bowel cleansing. It may lead to permanent renal impairment and a need for dialysis. The aetiology is hyperphosphataemia caused by intestinal absorption of the cleanser. Risk factors include: advanced age, existing kidney disease, decreased intravascular volume, and medications affecting renal perfusion or function such as diuretics, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and possibly nonsteroidal anti-inflammatory drugs.
Subject(s)
Cathartics/adverse effects , Colonoscopy , Enema/methods , Kidney Diseases/chemically induced , Phosphates/adverse effects , Administration, Oral , Cathartics/administration & dosage , Humans , Hyperphosphatemia/chemically induced , Nephrocalcinosis/chemically induced , Phosphates/administration & dosage , Polyethylene Glycols/administration & dosage , Polyethylene Glycols/adverse effects , Practice Guidelines as Topic , Renal Insufficiency/chemically induced , Risk Factors , Therapeutic IrrigationABSTRACT
Cameron lesions are linear gastric ulcers or erosions on the mucosal folds at the diaphragmatic impression in patients with a large hiatal hernia. The lesions are associated with occult bleeding and development of chronic iron deficiency anaemia, but are often overlooked during routine endoscopy. We present two patients with known hiatal hernias in who repeated endoscopic examinations had not been able to identify a source of bleeding. In both cases, typical Cameron lesions were found either by repeat gastroscopy or by capsule endoscopy. Treatment with high-dose proton pump inhibitor and iron supplement was initiated.