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Am J Kidney Dis. 2014 Sep;64(3):473-6. doi: 10.1053/j.ajkd.2014.05.010. Epub 2014 Jun 18.

Bile acid nephropathy in a bodybuilder abusing an anabolic androgenic steroid.

Author information

1
Section of Nephrology, Yale University School of Medicine, New Haven, CT.
2
Department of Pathology, Yale University School of Medicine, New Haven, CT.
3
Section of Nephrology, Yale University School of Medicine, New Haven, CT. Electronic address: mark.perazella@yale.edu.

Abstract

Bile acid nephropathy, also known as cholemic nephrosis or nephropathy, is an entity that can be seen in patients with severe cholestatic liver disease. It typically is associated with acute kidney injury (AKI) with various forms of hepatic disease. Most often, patients with severe obstructive jaundice develop this lesion, which is thought to occur due to direct bile acid injury to tubular cells, as well as obstructing bile acid casts. Patients with end-stage liver disease also can develop AKI, in which case a more heterogeneous lesion occurs that includes hepatorenal syndrome and acute tubular injury/necrosis. In this circumstance, acute tubular injury develops from a combination of hemodynamic changes with some contribution from direct bile acid-related tubular toxicity and obstructive bile casts. We present a case of AKI due to bile acid nephropathy in a bodybuilder who developed severe cholestatic liver disease in the setting of anabolic androgenic steroid use.

KEYWORDS:

Bile acid nephropathy; acute kidney injury; cholestatic jaundice

PMID:
24953892
DOI:
10.1053/j.ajkd.2014.05.010
[Indexed for MEDLINE]

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