An unexpected cause of progressive renal failure in a 66-year-old male after liver transplantation: secondary hyperoxaluria

Int Urol Nephrol. 2013 Aug;45(4):1209-13. doi: 10.1007/s11255-012-0140-1. Epub 2012 Mar 1.

Abstract

Background: Hyperoxaluria is a rare metabolic disorder characterized by calcium oxalate deposition in different tissues. It is caused either by an inherited disease of oxalate metabolism [primary hyperoxalurias (PH)] or by an acquired disturbance (secondary hyperoxaluria).

Case: We report here an atypical presentation of enteric hyperoxaluria-induced renal failure that occurred after liver transplantation. Despite adapted treatment and intensive haemodialysis, the patient did not recover. This case allows the reviewing of the multiple pathophysiological mechanisms involved in this disease.

Conclusion: Oxalate nephropathy should be considered in the differential diagnosis of acute renal failure, especially when previous renal impairment and fat malabsorption are present. We suggest performing renal biopsy early to allow a prompt diagnosis and therapeutic intervention.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / pathology*
  • Acute Kidney Injury / therapy
  • Aged
  • Biopsy, Needle
  • Calcium Oxalate / metabolism*
  • Calcium Oxalate / urine
  • Diagnosis, Differential
  • Disease Progression
  • Follow-Up Studies
  • Graft Rejection / diagnosis
  • Graft Rejection / pathology*
  • Graft Rejection / therapy
  • Humans
  • Hyperoxaluria / diagnosis
  • Hyperoxaluria / etiology
  • Hyperoxaluria / pathology*
  • Hyperoxaluria / therapy
  • Immunohistochemistry
  • Liver Failure / pathology
  • Liver Failure / surgery
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / methods
  • Male
  • Microscopy, Polarization
  • Renal Dialysis / methods
  • Risk Assessment

Substances

  • Calcium Oxalate