Open AccessIschemic colitis in association with sevelamer crystals
Author(s) -
KC Keri,
Vineet Veitla,
Naga Swetha Samji
Publication year - 2019
Publication title -
indian journal of nephrology/indian journal of nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.317
H-Index - 24
eISSN - 1998-3662
pISSN - 0971-4065
DOI - 10.4103/ijn.ijn_80_18
Subject(s) - medicine , sevelamer , ischemic colitis , hemodialysis , gangrene , dialysis , gastroenterology , inflammatory bowel disease , phosphate binder , perforation , necrosis , hyperphosphatemia , coagulative necrosis , diabetes mellitus , disease , colitis , kidney disease , surgery , endocrinology , materials science , punching , metallurgy
Sevelamer is an important drug used to lower serum phosphate levels in advanced kidney disease and in patients on dialysis. This drug is generally well tolerated but some patients report mild gastrointestinal distress as a side effect. Although regulatory agencies, such as Food and Drug Administration, list bowel ischemia and necrosis as potential and rare side effects, there are few case reports describing these adverse effects. We present a 35-year-old HIV patient with end-stage renal disease on hemodialysis who developed colonic hemorrhage and perforation. Imaging showed ischemic gangrene of bowel wall. Histopathology was consistent with transmural ischemic necrosis with deposition of fibrin thrombi and sevelamer crystals.