Management challenges in primary hyperoxaluria type 1 with end-stage kidney disease: A case report

Q4 Medicine Transplantation Reports Pub Date : 2024-12-01 DOI:10.1016/j.tpr.2024.100165
Mahdi Awwad , Nasim Afif AbuKaresh , Hamza A. Abdul-Hafez , Ma'moun Qawasmeh , Mohanad Jaber , Ahmad Thiab Albaw , Mohammad Alnees
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Abstract

Introduction and importance

Primary hyperoxaluria (PH) is a metabolic condition that leads to oxalate production, resulting in kidney failure and oxalate nephropathy. Posttransplant mobilization of oxalate poses a risk of recurrence. This case emphasizes the importance of measures in cases of end-stage kidney disease (ESKD) with unknown origins.

Case presentation

A 53-year-old man with a history of hypothyroidism, recurring kidney stones, and a family background of renal disease and stomach cancer presented with high blood pressure and elevated creatinine levels (2 mg/dL). A subsequent renal biopsy confirmed PH1. Despite initiating hemodialysis, his kidney function deteriorated, necessitating a liver and kidney transplant. Following the transplant, the patient developed lymph node enlargement. Experienced humoral rejection, leading to the resumption of hemodialysis.

Clinical discussion

The case discussion highlights the treatment complexities associated with PH1, emphasizing the importance of detection and vigilant monitoring post transplantation and multidisciplinary care for managing complications effectively.

Conclusion

Early detection, thorough diagnostics, and customized posttransplant care play roles in managing hyperoxaluria. Future research should focus on enhancing methods, refining transplantation techniques, and developing strategies to prevent and manage complications effectively.
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终末期肾病的原发性1型高草酸尿的管理挑战:1例报告
原发性高草酸尿(PH)是一种导致草酸生成的代谢疾病,可导致肾衰竭和草酸肾病。移植后草酸盐的移动有复发的风险。本病例强调了在病因不明的终末期肾病(ESKD)病例中采取措施的重要性。病例表现:53岁男性,有甲状腺功能减退、复发性肾结石病史,有肾脏疾病和胃癌家族史,并伴有高血压和肌酐升高(2 mg/dL)。随后肾活检证实PH1。尽管开始了血液透析,他的肾功能还是恶化了,需要进行肝脏和肾脏移植。移植后,患者出现淋巴结肿大。经历体液排斥,导致血液透析恢复。病例讨论强调了与PH1相关的治疗复杂性,强调了移植后检测和警惕监测以及多学科护理对有效管理并发症的重要性。结论早期发现、彻底诊断和个性化的移植后护理是治疗高草酸尿的重要手段。未来的研究应着眼于改进移植方法,改进移植技术,制定有效预防和管理并发症的策略。
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来源期刊
Transplantation Reports
Transplantation Reports Medicine-Transplantation
CiteScore
0.60
自引率
0.00%
发文量
24
审稿时长
101 days
期刊介绍: To provide to national and regional audiences experiences unique to them or confirming of broader concepts originating in large controlled trials. All aspects of organ, tissue and cell transplantation clinically and experimentally. Transplantation Reports will provide in-depth representation of emerging preclinical, impactful and clinical experiences. -Original basic or clinical science articles that represent initial limited experiences as preliminary reports. -Clinical trials of therapies previously well documented in large trials but now tested in limited, special, ethnic or clinically unique patient populations. -Case studies that confirm prior reports but have occurred in patients displaying unique clinical characteristics such as ethnicities or rarely associated co-morbidities. Transplantation Reports offers these benefits: -Fast and fair peer review -Rapid, article-based publication -Unrivalled visibility and exposure for your research -Immediate, free and permanent access to your paper on Science Direct -Immediately citable using the article DOI
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