Acute phosphate nephropathy with intratubular calcium phosphate deposition that somewhat resembles the pathology of our patients is caused by oral sodium phosphates used for bowel preparation before colonoscopy [ 24 ]. Protein powder contains little inorganic phosphate with three daily supplement servings providing < g [ 25 ]. Creatine is sold mainly in the form of a monohydrate also with little phosphorus. Daily 2–3 L milk consumption will add – g to a normal dietary phosphorus intake of – g [ 25 ]. This is well below the 11 g oral intake used in bowel preparations [ 24 ]. In addition, the negative von Kossa stains indicates that the mainly amorphous tubular concretions found in the kidneys of our patients were acutely precipitated and had not complexed into crystalline hydroxyapatite with prominently stained phosphates that are seen in hyperphosphatemic nephropathy as well as other forms of neprocalcinosis [ 26 ].
Our nephrologists have specialty training and expertise in disease management that is recognized regionally and nationally. We have specialists in kidney transplantation, glomerular kidney diseases, bone diseases, dialysis including acute and home dialysis, kidney stones, dialysis access management and high blood pressure. The physicians of UofL Physicians-Kidney Disease Program volunteer their time with the National Kidney Foundation, offering free screenings at community events. We also support patient education through our Chronic Kidney Disease Program, which helps patients navigate the five stages of kidney disease. Our physicians collaborate with primary care and other UofL Physicians specialty teams to provide comprehensive and continuous care through the different stages of kidney disease.