Supplementary file 1_Successful treatment of pediatric acute phosphate nephropathy: a case report and literature review.docx

BackgroundAcute phosphate nephropathy is a type of acute kidney injury caused by the deposition of calcium phosphate crystals in the renal tubules- and interstitium. Currently, there have been no reported cases of acute phosphate nephropathy in children. Its typical manifestations include frequent urination, urgency, foamy urine, and impaired renal function, which is often accompanied by hypercalcemia and hypercalciuria, while patients may also experience severe symptoms such as acute renal failure.
Case reportThis article reports a case of acute phosphate nephropathy in a 9-year and 4-month-old child most likely caused by long-term use of alpha-calcidol. The child presented with frequent urination, urgency, foamy urine, elevated blood calcium and urinary calcium, increased blood creatinine, and urinary ultrasound suggested possible calcium salt deposition in the renal pyramids of both kidneys. Renal biopsy indicated a significant deposition of calcium phosphate salts in the renal tubular interstitium. After combined traditional Chinese and Western medicine treatment, the child’s blood calcium, urinary calcium, and blood creatinine levels gradually decreased to normal.
ConclusionThis first reported case of acute phosphate nephropathy in child was possibly caused by long-term use of alpha-calcidol. The patient achieved good results following a comprehensive treatment plan combining traditional Chinese and Western medicine. This approach not only promoted the recovery of renal function but also offered valuable insights for clinical practice. Additionally, recent literature is reviewed to discuss the etiology, pathogenic mechanisms, and treatment strategies of this disease, aiming to enhance clinical physicians’ awareness and vigilance regarding such conditions.