Nephrocalcinosis and Foam Cell-Rich Medullary Interstitial Nephropathy in a Patient with Laxative-Induced Hypokalemia: A Case Report

Chronic laxative abuse is a known cause of hypokalemia; however, the full spectrum of kidney-related consequences remains underexplored. We herein report the incidental identification of hypokalemia and kidney dysfunction in a 62-year-old woman with long-standing laxative dependence. Imaging revealed bilateral multifocal renal calcification and a renal biopsy demonstrated extensive tubulointerstitial fibrosis with prominent clustering of CD68-positive foam cells in the medullary interstitium. These findings suggest a potential link between laxative-induced hypokalemia, renal calcification, and foam cell infiltration. Therefore, this case may represent a rare or underrecognized presentation, thereby underscoring the need for the clinical awareness of laxative abuse.

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Journal
Internal Medicine
Published
2026-01-01
DOI
https://doi.org/10.2169/internalmedicine.6686-25
Primary Topic
Potassium and Related Disorders
Type
article
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article

Nephrocalcinosis and Foam Cell-Rich Medullary Interstitial Nephropathy in a Patient with Laxative-Induced Hypokalemia: A Case Report

Go Kanzaki, Kei Matsumoto, Akimitsu Kobayashi, Aoi Miyashita et al.
Internal Medicine
Potassium and Related Disorders
article

Nephrocalcinosis and Foam Cell-Rich Medullary Interstitial Nephropathy in a Patient with Laxative-Induced Hypokalemia: A Case Report

Go Kanzaki, Kei Matsumoto, Akimitsu Kobayashi, Aoi Miyashita, Ryoko Sakaguchi, Kensuke Joh, Nobuo Tsuboi, Takashi Yokoo, Shiko Honma
article en

Abstract

Chronic laxative abuse is a known cause of hypokalemia; however, the full spectrum of kidney-related consequences remains underexplored. We herein report the incidental identification of hypokalemia and kidney dysfunction in a 62-year-old woman with long-standing laxative dependence. Imaging revealed bilateral multifocal renal calcification and a renal biopsy demonstrated extensive tubulointerstitial fibrosis with prominent clustering of CD68-positive foam cells in the medullary interstitium. These findings suggest a potential link between laxative-induced hypokalemia, renal calcification, and foam cell infiltration. Therefore, this case may represent a rare or underrecognized presentation, thereby underscoring the need for the clinical awareness of laxative abuse.

Internal Medicine
Jikei University School of Medicine (JP), The Jikei University Hospital (JP)
Zero hunger
Openalex Percentile: Top 13%
Potassium and Related Disorders
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Nephrocalcinosis and Foam Cell-Rich Medullary Interstitial Nephropathy in a Patient with Laxative-Induced Hypokalemia: A Case Report — Go Kanzaki, Kei Matsumoto, et al. · Internal Medicine (2026) | TGRS Research Map | TGRS