Hypophosphatemia in kidney transplant recipients: report of acute phosphate nephropathy as a complication of therapy

Am J Kidney Dis. 2011 Apr;57(4):641-5. doi: 10.1053/j.ajkd.2010.11.024. Epub 2011 Feb 18.

Abstract

Hypophosphatemia is a common complication after kidney transplant, affecting >90% of patients. However, no specific recommendations for phosphate repletion exist for transplant recipients. We report a case of a 70-year-old highly sensitized woman with end-stage renal disease caused by diabetic nephropathy who underwent deceased donor kidney transplant. Four weeks later, she was noted to have hypophosphatemia with undetectable serum phosphate levels, and she reported mild diarrhea. She was started on oral phosphate supplementation. On a routine visit 2 weeks later, she was found to have an acute increase in serum creatinine level and kidney biopsy was performed. We discuss the causes, management, and complications of hypophosphatemia in kidney transplant.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetates / therapeutic use
  • Administration, Oral
  • Aged
  • Biopsy
  • Calcium Compounds / therapeutic use
  • Creatinine / blood
  • Female
  • Humans
  • Hypophosphatemia / drug therapy*
  • Hypophosphatemia / etiology*
  • Kidney / pathology
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / adverse effects*
  • Phosphates / administration & dosage
  • Phosphates / adverse effects*
  • Phosphates / therapeutic use*
  • Renal Insufficiency / chemically induced*
  • Renal Insufficiency / diagnosis
  • Renal Insufficiency / drug therapy
  • Treatment Outcome

Substances

  • Acetates
  • Calcium Compounds
  • Phosphates
  • Creatinine
  • calcium acetate