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Volume 359:2501 December 4, 2008 Number 23
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Case 27-2008: A Man with Abdominal Pain, Nausea, and an Elevated Creatinine Level

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by Steinman, T. I.
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To the Editor: In the Case Record of a 64-year-old man with abdominal pain and an elevated level of serum creatinine (Aug. 28 issue),1 a kidney-biopsy specimen revealed findings that were diagnostic of acute phosphate nephropathy. Severe abdominal pain was attributed to gastroesophageal reflux after pancreatobiliary disease had been ruled out. Chronic mesenteric ischemia is not mentioned in the discussion. This disorder, which develops in patients with a mean age of 58 years, would account for the uncontrolled severe epigastric pain, nausea, and vomiting (with secondary dehydration and acute renal failure), as well as the anorexia and occult blood in . . . [Full Text of this Article]



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