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Diagnosis: Acute phosphate nephropathy
Acute phosphate nephropathy is a form of kidney injury that occurs following the use of bowel purgatives that contain oral sodium phosphate and has been reported following the administration of sodium phosphate-containing enemas. The mechanism underlying acute phosphate nephropathy most likely relates to a transient but potentially severe increase in serum phosphate coupled with volume depletion, both of which may occur following the administration of bowel purgatives that contain oral sodium phosphate. The chief pathologic characteristic of acute phosphate nephropathy is extensive deposition of calcium phosphate in the tubular lumina, within tubular epithelial cells, and, less commonly, in the peritubular interstitium. Calcium phosphate deposits are distinguished from calcium oxalate deposits by positive staining with the "von Kossa stain" and the absence of birefringence under polarized light. [Markowitz GS, Parazella MA. Acute phosphate nephropathy. In UpToDate. Consulted: October 20th, 2015 (Link)].
In our case, the patient presented complete remision of the renal alterations two weeks later.
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References
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Monfared A, Habibzadeh SM, Mesbah SA. Acute phosphate nephropathy. Iran J Kidney Dis. 2014 May;8(3):246-9. [PubMed link].
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Markowitz GS, Parazella MA. Acute phosphate nephropathy. In UpToDate. Consulted: October 20th, 2015 (Link) .
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Choi NK, Lee J, Chang Y, Kim YJ, Kim JY, Song HJ, Shin JY, Jung SY, Choi Y, Lee JH, Park BJ. Acute renal failure following oral sodium phosphate bowel preparation: a nationwide case-crossover study. Endoscopy. 2014 Jun;46(6):465-70. [PubMed link]
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Rao S, Calderwood AH. Safety first: the case against oral sodium phosphate. Endoscopy. 2014 Jun;46(6):471-2. [PubMed link]
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Scanni R, vonRotz M, Jehle S, Hulter HN, Krapf R. The human response to acute enteral and parenteral phosphate loads. J Am Soc Nephrol. 2014 Dec;25(12):2730-9. [PubMed link]