Bile cast nephropathy refers to acute kidney injury (AKI) associated with severe hyperbilirubinemia.
Clinical features:
(1) severe hyperbilirubinemia
(2) acute kidney injury not due to other cause
Key pathologic features: acute tubular necrosis (ATN) with yellow-green pigment within tubular epithelial cells and with yellow pigmented granular casts.
The casts are positive for bile (Hall's stain).
Renal ischemia may contribute to the renal injury.
Reversal of the hyperbilirubinemia is associated with gradual recovery of renal function.
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