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Silica nanoparticles are used in functional foods and tablets to increase drug stability and delivery. We investigated a patient with acute kidney injury with Fanconi syndrome after taking functional food tablets made from red yeast rice using low-vacuum scanning electron microscopy (LVSEM) with an element analysis system. Kidney biopsy revealed proximal tubular necrosis and vacuolization with 10–20 nm black granules, which were similar to the silica nanoparticles found in the functional food tablets and urinary samples, as determined via LVSEM with element analysis. Reabsorbed silica nanoparticles induce oxidative stress in the kidney. Element analysis by LVSEM is useful to investigate a possible cause of acute tubular necrosis in patients with Fanconi syndrome. [ABSTRACT FROM AUTHOR]

Tumor-induced osteomalacia (TIO) is a rare acquired paraneoplastic syndrome caused by a mesenchymal tumor secreting a phosphaturic hormone called FGF23. Patients present with bone pain, fragility fractures and muscle weakness. Biochemical results show hypophosphatemia, raised serum alkaline phosphatase and reduced calcitriol. We report the case of a 44-year-old man who presented to the Emergency Departement with acute low back pain revealing extensive subchondral fractures between D2 and L5. Investigations showed partial Fanconi syndrome; nevertheless, he had profound hypophosphatemia, low 1,25-OH vitamin D and raised FGF23 levels suggesting a diagnosis of tumor-induced osteomalacia. A subcutaneous lesion was identified in the left leg on a PET-CT initially performed to rule out malignancy in the context of Fanconi syndrome. Tumorectomy enabled complete resolution of the electrolyte disturbances within days of surgery. This case shows that TIO may present as partial Fanconi syndrome, highlighting the importance of testing other electrolytes in cases of hypophosphatemia and the need to look for TIO in cases of partial Fanconi with severe hypophosphatemia. [ABSTRACT FROM AUTHOR]

The obituary for Prof. Stephen (Ben) Walsh, a Professor of Nephrology at University College London, highlights his unique personality and professional achievements. Ben was known for his wit, dedication to research, and ability to connect seemingly unrelated fields in renal physiology. Despite facing setbacks in funding, he persevered and made significant contributions to the field, including groundbreaking work on kidney function in space flight. Ben's legacy as a respected clinician-scientist, teacher, and mentor is remembered fondly by his colleagues, family, and friends. [Extracted from the article]

We herein report a case of acute kidney injury and Fanconi syndrome associated with a red yeast rice supplement. A 72-year-old woman's serum creatinine rose from 0.7 to 3.97 mg/dL after starting the supplement, accompanied by metabolic acidosis, proteinuria, hematuria, and glucosuria. A kidney biopsy showed proximal tubular injury without abundant tubulitis. Immunostaining showed dilated tubules that were positive for CD10, confirming proximal tubule localization. Discontinuation of the supplement and steroid pulse therapy improved the patient's condition. This case highlights the health risks associated with unregulated dietary supplementation.