Bile Acids as Metabolic Modulators

Kidney injury in deeply jaundiced patients became known as cholemic nephropathy. This umbrella term covers impaired renal function in cholestatic patients with characteristic histomorphological changes including intratubular cast formation and tubular epithelial cell injury. Cholemic nephropathy represents a widely underestimated but important cause of kidney dysfunction in patients with cholestasis and advanced liver disease. However, the nomenclature is inconsistent since there are numerous synonyms used; the underlying mechanisms of cholemic nephropathy are not entirely clear, and widely accepted diagnostic criteria are still missing. Consequently, the current article aims to summarize the present knowledge on the clinical and morphological characteristics, available preclinical models, derived potential pathomechanisms, and future diagnostic and therapeutic strategies in cholemic nephropathy. Furthermore, we provide a potential research agenda for this evolving field. © 2015 S. Karger AG, Basel Peter Fickert, MD Research Unit for Experimental and Molecular Hepatology Division of Gastroenterology and Hepatology, Department of Internal Medicine Medical University of Graz, Auenbruggerplatz 15, AT–8036 Graz (Austria) E-Mail peter.fickert @ medunigraz.at © 2015 S. Karger AG, Basel 0257–2753/15/0333–0367$39.50/0