Colonic Mucosal Ulceration and Gastrointestinal Bleeding Associated with Sevelamer Crystal Deposition in a Patient with End Stage Renal Disease
Joint Authors
Pillai, Unnikrishnan
Nambiar, Sudheer
Karippot, Asha
Devasahayam, Joe
Oliver, Tony
Source
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-3, 3 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-02-28
Country of Publication
Egypt
No. of Pages
3
Main Subjects
Abstract EN
End stage renal disease (ESRD) population account for 1.9 per patient year of hospital admissions annually.
ESRD population are at increased risk of bleeding secondary to use of anticoagulation during hemodialysis and uremia induced platelet dysfunction.
Gastrointestinal bleeding accounts for 3–7% of all deaths in ESRD population.
Lower gastrointestinal bleeding refers to blood loss from a site in the gastrointestinal tract distal to the ligament of Treitz.
It is usually suspected when a patient complains of hematochezia.
It is different from patients presenting with hematemesis that suggests bleeding from upper gastrointestinal tract.
Common causes of lower gastrointestinal bleed include diverticulosis, ischemia, hemorrhoids, neoplasia, angiodysplasia, and inflammatory bowel disease.
ESRD patients are known to retain phosphate alone or in combination with calcium which has been associated with high mortality.
Sevelamer is a phosphate binder used widely in ESRD population.
The known side effects of sevelamer include metabolic acidosis, vomiting, nausea, diarrhea, dyspepsia, abdominal pain, constipation, flatulence, fecal impaction, and skin rash.
We are reporting a unique case of a 56-year-old female with end stage renal disease on sevelamer hydrochloride who presented with gastrointestinal bleeding and underwent a right hemicolectomy found to have sevelamer-induced mucosal ulceration and crystal deposition in the colonic mucosa.
This case report highlights the fact that, with widespread use of this medication in the patients with chronic kidney diseases, physicians should be aware of this underrecognized entity in the differential diagnosis of gastrointestinal bleed in ESRD patients.
American Psychological Association (APA)
Nambiar, Sudheer& Pillai, Unnikrishnan& Devasahayam, Joe& Oliver, Tony& Karippot, Asha. 2018. Colonic Mucosal Ulceration and Gastrointestinal Bleeding Associated with Sevelamer Crystal Deposition in a Patient with End Stage Renal Disease. Case Reports in Nephrology،Vol. 2018, no. 2018, pp.1-3.
https://search.emarefa.net/detail/BIM-1145202
Modern Language Association (MLA)
Nambiar, Sudheer…[et al.]. Colonic Mucosal Ulceration and Gastrointestinal Bleeding Associated with Sevelamer Crystal Deposition in a Patient with End Stage Renal Disease. Case Reports in Nephrology No. 2018 (2018), pp.1-3.
https://search.emarefa.net/detail/BIM-1145202
American Medical Association (AMA)
Nambiar, Sudheer& Pillai, Unnikrishnan& Devasahayam, Joe& Oliver, Tony& Karippot, Asha. Colonic Mucosal Ulceration and Gastrointestinal Bleeding Associated with Sevelamer Crystal Deposition in a Patient with End Stage Renal Disease. Case Reports in Nephrology. 2018. Vol. 2018, no. 2018, pp.1-3.
https://search.emarefa.net/detail/BIM-1145202
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1145202