A Case of Oxalate Nephropathy: When a Single Cause Is Not Crystal Clear

Am J Kidney Dis. 2017 Nov;70(5):722-724. doi: 10.1053/j.ajkd.2017.05.022. Epub 2017 Jul 21.

Abstract

Hyperoxaluria can result in oxalate nephropathy with intratubular calcium oxalate crystallization and acute tubular injury. Primary inherited enzymatic deficiency or secondary causes such as excessive dietary intake, enteric increased absorption, or high doses of vitamin C, which is metabolized to oxalate, may underlie hyperoxaluria and oxalate nephropathy. We report a case of acute kidney injury due to oxalate nephropathy in a patient using chelating therapy with oral ethylenediamine tetra acetic acid (EDTA), intravenous supplementation with vitamin C, and chronic diarrhea and discuss the potential kidney damage these factors can cause in particular settings. To our knowledge, this is the first report suggesting an association between oral EDTA and oxalate nephropathy.

Keywords: EDTA; Oxalate nephropathy; acute kidney injury (AKI); acute tubular injury; ascorbic acid; calcium oxalate; case report; hyperoxaluria; kidney biopsy; kidney failure; vitamin C.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / etiology*
  • Acute Kidney Injury / pathology
  • Acute Kidney Injury / therapy
  • Aged
  • Ascorbic Acid / adverse effects*
  • Calcium Chelating Agents / adverse effects*
  • Calcium Oxalate*
  • Diarrhea / complications*
  • Edetic Acid / adverse effects*
  • Humans
  • Hyperoxaluria / etiology*
  • Kidney Tubular Necrosis, Acute / etiology
  • Kidney Tubular Necrosis, Acute / pathology
  • Male
  • Renal Dialysis
  • Vitamins / adverse effects*

Substances

  • Calcium Chelating Agents
  • Vitamins
  • Calcium Oxalate
  • Edetic Acid
  • Ascorbic Acid