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What causes bile cast nephropathy?  
Many questions surround bile cast nephropathy as a diagnosis. Is bilirubin nephrotoxic or do the conditions associated with hyperbilirubinemia lead to acute kidney injury (AKI)? Which comes first? AKI from something else with bile casts forming because of stagnant tubular flow, or high concentrations of bile causing direct tubular injury with subsequent AKI? Share your thoughts.

Summary provided by Roger Rodby, MD, FASN.
Previous Community Minded Summaries are available at: https://community.asn-online.org/browse/communityminded