Table 1 Summary of the clinical and pathological characteristics of all biopsy proven bile cast nephropathy reported in literature since 2000
Author | Age (year)/Gender | Primary disease | Bilirubin level (mg/dL) | Peak creatinine (mg/dl) | Biopsy findings | Therapies used | Outcome |
|---|---|---|---|---|---|---|---|
Bal et al. [30] | NA (3 cases) | Subacute hepatic failure | 20 (T) | _ | Mesangial proliferation and thickening, basement membrane thickening, presence of hyaline, granular and bile casts | _ | _ |
Kiewe et al. [31] | 40/F | Hodgkin’s lymphoma | 30.4 (D) | 1.7 | Hypertrophy of tubular epithelium Bile casts in distal and collecting tubules | Hemodialysis | Resolution of kidney injury and discontinuation of hemodialysis |
Betjes et al. [32] | NA (2 cases) | Obstructive jaundice in patient A, autoimmune hepatitis in patient B | 36.2 (T) 33.2 (T) | _ | Bilirubin pigment in the tubules Tubular cell necrosis | _ | Improvement of renal function along with decrease in bilirubin level in patient A Patient B died |
Uslu et al. [33] | NA (20 cases) | Obstructive jaundice | 10.1 (T) | _ | Dilatation of peritubular venules, acute tubular necrosis | _ | Absolute recovery of renal function in all patients after biliary drainage |
De Fijjter et al. [10] | 38/M | EBV infection | 28.5 (D) | 3.25 | ATN features Abundant bile casts | Hemodialysis | Resolution of infection and hyperbilirubinemia Discontinuation of hemodialysis |
Burbach et al. [15] | 46/M | Cholangio-carcinoma | 20.9 (D) | 6 | Presence of tubular damage: loss of brush border, tubular necrosis Bile casts and thrombi in proximal and distal tubules | Renal replacement therapy | Patient passed away |
Van Slambrouck et al. [3] | NA (24 cases) | Obstructive cholestasis | 24.9 (T) | _ | Bile casts with involvement of distal nephron segments | _ | _ |
Castano et al. [19] | 41/M | Anabolic steroid abuse | 7.9 (T) | 2.9 | Multiple green-brown casts in the distal tubules Diffuse ATN with dilatation of tubular lumen, vacuolization of tubular cell cytoplasm, and apical blebbing | No hemodialysis | Kidney function improved over 4 months and Cr plateaued at 1.8 mg/dL |
Van der Wijngaart et al. [11] | 73/M | Obstructive jaundice with multiple gallstones in the common bile duct | 39.6 (T) | 7.35 | Bile casts, reactive changes of tubular epithelial cells | Hemodialysis, biliary drain | Improvement of kidney function after 5 weeks |
Tabatabaee et al. [34] | 30/M | Stanozolol abuse | 28 (D) | 8.7 | Preserved glomeruli Degeneration of cortical tubules Bile casts present in some tubules | Hemodialysis | Cr level decreased to 2.5 mg/dL in 2 months |
|  | 43/M | Stanozolol abuse | 45 (D) | 5.4 | ATN, bile pigment deposition | Hemodialysis | Cr decreased to 1.8 mg/dL at 2 months |
Alkhunaizi et al. [35] | 28/M | Anabolic steroid abuse | 29.9 (D) | 2.6 | Glomeruli unremarkable Acute tubular injury with luminal ectasia Dark green bile casts within tubular lamina | Supportive care only, no dialysis | At 3 month follow up: Serum Creatinine returned to normal at 1.1 mg/dL Serum total bilirubin dropped to 1.8 mg/dL |
Sequeira and Gu [28] | 41/F | Acute alcoholic hepatitis | 20 (D) | 9.2 | Normal glomeruli Intra-tubular bile casts shown by Hall’s Stain | Hemodialysis | Urine output improved gradually, however patient continued to need dialysis for poor clearance |
Kshiragar et al. [36] | 55/M | Colorectal cancer metastatic to liver | 25 (D) | 2.72 | Intratubular bile casts | _ | _ |
Alalawi [12] | 61/F | Acute liver injury | 7 (T) | 7.3 | Positive Fouchet stain indicating presence of Bilirubin casts | 7 sessions of hemodialysis | Recovered kidney function Discharge Cr = 1.1 mg |
Flores et al. [37] | 31/M | Anabolic steroid induced cholestasis | 53 (T) | 2.3 | Yellow, brown intraluminal tubular casts Flattening and simplification of the epithelial lining | 5 sessions of plasmapheresis No hemodialysis | Bilirubin level decreased Cr level decreased and patient recovered kidney function |
Alnasrallah et al. [4] | 60/M | Flucloxacillin induced liver injury | 34 (D) | 6.6 | Normal Glomeruli Positive bile stain and bile casts in tubules | No hemodialysis | Bilirubin level decreased Cr level decreased to stabilize at 1.85 mg/dL |
Sens et al. [26] | 37/M | TCF 2 Mutation induced biliary duct dystrophy | 15.2 (D) | 5.8 | Acute tubular injury: dilated tubules with flattened epithelium Greenish-brown intraluminal casts | Hemodialysis 9 ECAD:1 MARS and 8 SPAD sessions | Patient underwent simultaneous liver kidney transplant |
Patel et al. [2] | 54/M | Acute liver injury | 29 (T) | 5.47 | Proximal and distal tubules containing bile casts | Hemodialysis | Patient underwent simultaneous liver and kidney transplant Normalization of kidney and hepatic indices |
Werner et al. [38] | 76/M | Painless jaundice due to cholangiocellular carcinoma | _ | _ | Dilated tubules, bile casts | bile duct stent, Hemodialysis | Resolution of renal function after restoration of cholestasis |
Mohapatra et al. [39] | NA (20 cases) | Severe falciparum malaria complicated with jaundice | 26.5 (T) | _ | Numerous tubular casts, acute tubular necrosis but maintained glomerular architecture | _ | Recovery time of renal dysfunction 15.1 ± 6.5 days |
Leclerc et al. [40] | 78/M | Drug-induced hepatic jaundice | 30.93 (T) | 7.1 | Brown casts clogging the tubular lumen, brown deposits in the cytoplasm of tubular epithelial cells | Hemodialysis | Improvement of kidney function after normalization of bilirubin and hemodialysis |
Aniort et al. [41] | 61/M | CBD stones induced obstructive jaundice | 32.6 (T) | 5.3 | Bilirubin tubular casts predominated in distal tubules | ERCP, cholecystectomy | Kidney function fully recovered to Cr level of 0.9 mg/dL after 3 months |