二磷酸果糖注射液致急性高磷血症、肾功能衰竭5例

目的:探讨注射用二磷酸果糖致急性高磷血症的临床特点及诱发急性肾功能衰竭的发病机理。方法:回顾性分析2003-2005年我院发生的5例二磷酸果糖致急性高磷血症患者临床资料。1例患者行肾组织病理学检查。结果:5例病人血磷均明显升高,达6.15～9.99mmol/L,临床出现急性肾功能衰竭或慢性肾功能不全急性加重及多系统损害。肾脏病理学检查显示急性肾小管间质性肾病,肾小管腔内及小血管壁钙化。结论:二磷酸果糖可引起严重急性高磷血症,导致多系统损害,以急性肾功能衰竭为突出表现。肾损伤的机制可能为急性肾钙质沉着。

Acute hyperphosphatemia and renal failure due to fructose diphosphate injection

Objective: To investigate the clinical characteristics and mechanism of renal failure due to acute hyperphosphatemia following intravenous fructose diphosphate injection. Methods: Five patients with renal failure due to acute hyperphosphatemia following intravenous fructose diphosphate were retrospectively studied. One patient underwent renal biopsy and the specimens were processed for pathological test. Results: Five patients had an elevation of serum phosphorus around 6.15-9.99mmol/L with polysystemic injury and acute renal failure or chronic renal function insufficient. The pathological finding showed that an acute tubular interstitial nephropathy with calcium deposit in tubular cavity and the wall of microvessels. Conclusion: Fructose diphosphate could cause severe hyperphosphatemia and adverse reactions in many systems especially in kidney. The mechanism of renal failure could be acute nephrocalcinosis.