Diet-induced hyperoxaluria: A case based mini-review.

Clinical nephrology. Case studies Pub Date : 2024-10-02 eCollection Date: 2024-01-01 DOI:10.5414/CNCS111505
Aman Pal, Emmanuel Aydin-Ghormoz, Andrea Lightle, Geovani Faddoul
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Abstract

Introduction: Oxalate nephropathy (ON) is a rare condition involving the precipitation of calcium oxalate crystals within the nephrons. Primary hyperoxaluria involves enzymatic defects in the metabolism of glyoxylate, while secondary hyperoxaluria includes dietary and malabsorption-related etiologies.

Case presentation: We discuss the case of a White male in his 80s who presented to the hospital with acute kidney injury on chronic kidney disease stage 4 in the setting of a new antibiotic prescription. Creatinine had increased to 4.2 mg/dL from a baseline of 2.2 mg/dL, with no etiology identified on urinalysis or renal ultrasound. Renal biopsy then revealed an acute tubular injury with intraluminal calcium oxalate crystals deposits, confirming a diagnosis of ON.

Discussion: A detailed history revealed an excessive dietary intake of oxalate-rich foods, including nuts, and daily ingestion of 2 g of vitamin C. The patient was counselled on adjusting his diet and stopping vitamin C supplementation, which led his creatinine to return close to baseline 2 months post-discharge.

Conclusion: Thorough history-taking enables early recognition and timely interventions to possibly avoid hyperoxaluria from progressing to end-stage kidney disease (ESRD).

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饮食诱发的高草酸尿症:基于病例的微型综述。
简介草酸盐肾病(ON)是一种涉及肾小球内草酸钙晶体沉淀的罕见疾病。原发性高草酸尿症涉及乙醛酸代谢过程中的酶缺陷,而继发性高草酸尿症则包括与饮食和吸收不良有关的病因:我们讨论的病例是一名 80 多岁的白人男性,他因慢性肾脏病 4 期急性肾损伤入院,当时正在服用一种新的抗生素。肌酐从基线值 2.2 毫克/分升升高至 4.2 毫克/分升,尿液分析或肾脏超声波检查均未发现病因。随后进行的肾活检显示,患者的肾小管急性损伤,管腔内有草酸钙结晶沉积,确诊为急性肾功能不全:详细询问病史后发现,患者从饮食中摄入了过多富含草酸盐的食物,包括坚果,并且每天摄入 2 克维生素 C:全面的病史采集有助于早期识别和及时干预,从而避免高草酸尿症发展为终末期肾病(ESRD)。
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