Liver Graft Failure and Bile Cast Nephropathy
10.4166/kjg.2020.75.3.167
- Author:
Anna MRZLJAK
1
;
Zeljka JUREKOVIC
;
Rafaela NOVAK
;
Bojana MAKSIMOVIC
;
Danko MIKULIC
;
Danica GALESIC LJUBANOVIC
Author Information
1. Department of Internal Medicine, Merkur University Hospital, Zagreb, Croatia. anna.mrzljak@mef.hr
- Publication Type:Case Report
- Keywords:
Liver transplantation;
Liver failure;
Cholestasis;
Acute kidney injury;
Hyperbilirubinemia
- From:The Korean Journal of Gastroenterology
2020;75(3):167-171
- CountryRepublic of Korea
- Language:English
-
Abstract:
The consequences of graft failure after liver transplantation (LT) range far beyond the liver. The kidneys are often affected, where persistent and progressive cholestasis can result in acute kidney injury (AKI) leading to the development of bile cast nephropathy (BCN). BCN is an often unrecognized condition that is characterized by proximal tubulopathy and the formation of bile casts in the distal tubules, which is almost diagnosed exclusively on a kidney biopsy or autopsy. This condition is potentially reversible, provided the bilirubin levels can be reduced early. LT may represent a treatment option in the case of irreversible liver (or liver graft) failure, which is beneficial for both the liver and the kidney. This paper reports a case of BCN in a patient with idiopathic graft failure after LT. Despite his chronic kidney disease, liver re-transplantation led to the successful improvement of his AKI.
