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Nephrology & Renal Medicine

Acquired Fanconi Syndrome

ICD-10 Code
N15.8_1

Generalized dysfunction of the proximal convoluted tubule leading to massive urinary wasting of glucose, amino acids, uric acid, phosphate, and bicarbonate. Often drug-induced (Tenofovir, Ifosfamide) or secondary to Multiple Myeloma (Light Chain Casts).

Clinical Presentation & Protocol

Patient Usually Complains Of

Patient presents with clinical features suggestive of proximal tubular dysfunction, including polyuria, polydipsia, and generalized weakness. History significant for [Drug Exposure/Underlying Malignancy]. Labs demonstrate normoglycemic glycosuria, hypophosphatemia, hypouricemia, and hyperchloremic metabolic acidosis.

Clinical Examination Findings

General appearance: Patient appears [well/ill-appearing], potentially cachectic if secondary to malignancy. Vital signs: Tachycardia or tachypnea may be present if acidosis is severe. Skin: Check for signs of dehydration (poor turgor, dry mucous membranes). Bone tenderness may be present due to osteomalacia.

Treatment Protocol

1. Discontinue offending nephrotoxic agent. 2. Correct electrolyte imbalances: Oral phosphate supplementation, potassium citrate for metabolic acidosis, and Vitamin D/calcium for bone health. 3. Treat underlying cause (e.g., chemotherapy for Multiple Myeloma). 4. Monitor renal function and tubular markers closely.

Detailed clinical guide coming soon.