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Official publication of the Indian Society of Nephrology
Ahead of Print

Ischemic Colitis in Association with Sevelamer Crystals

1 Department of Medicine, Division of Nephrology, Medical College of Wisconsin, Milwaukee, WI, USA
2 Department of Internal Medicine, Primary Care, Bellin Health, Marinette, WI, USA

Correspondence Address:
KC Keri,
Department of Medicine, Division of Nephrology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_80_18

Sevelamer is an important drug used to lower serum phosphate levels in advanced kidney disease and in patients on dialysis. This drug is generally well tolerated but some patients report mild gastrointestinal distress as a side effect. Although regulatory agencies, such as Food and Drug Administration, list bowel ischemia and necrosis as potential and rare side effects, there are few case reports describing these adverse effects. We present a 35-year-old HIV patient with end-stage renal disease on hemodialysis who developed colonic hemorrhage and perforation. Imaging showed ischemic gangrene of bowel wall. Histopathology was consistent with transmural ischemic necrosis with deposition of fibrin thrombi and sevelamer crystals.

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Indian Journal of Nephrology
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