Bile cast nephropathy: When the kidneys turn yellow

Alissar El Chediak, Khaled Janom, Sahar H. Koubar

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations


Kidney injury is a common finding in patients with liver disease. Bile cast nephropathy (also known as cholemic nephropathy) is an overlooked cause of renal injury in patients with hyperbilirubinemia. It can occur as a result of the toxic effects of bilirubin and bile acids on the renal tubules via several mechanisms. Bile cast nephropathy has characteristic histopathological changes consisting of bilirubin cast deposition in the distal nephron along with tubular epithelial cell injury. Treatment is based on the reversal of liver injury. This review aims to describe bile cast nephropathy in terms of its clinical and morphological features and to shed light on diagnostic techniques. In addition, we present data on management of such nephropathy while reviewing all the reported cases of bile cast nephropathy.

Original languageEnglish (US)
Article number15
JournalRenal Replacement Therapy
Issue number1
StatePublished - Mar 17 2020

Bibliographical note

Publisher Copyright:
© 2020 The Author(s).


  • Bile cast nephropathy
  • Cholemic nephropathy
  • Extracorporeal therapy
  • Hyperbilirubinemia


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